Simůnek R, Sirotek L, Sefr R
Chirurgické oddelení, Masarykův onkologický ustav, Brno.
Rozhl Chir. 2011 Mar;90(3):190-3.
We present rare case of clear cell renal carcinoma metastasis into common bile duct. It is a 9th case listed on the MEDLINE data base from 1966 to 2010.71-year-old woman underwent right nefrectomy for renal cancer G1 in 1986. She was reoperated in 2006 for relaps in renal bed on the right side. Histological examination confirmed clear cell renal carcinoma again. At present, a new liver metastasis in S 4/5 was detected. During the operation we found first described liver metastasis and second another one in common bile duct with intraluminal growth. Before surgery the patient showed neither clinical nor laboratory marks of biliary obstruction. Even abdominal ultrasound, SONO VUE, CT and body PET were negative. We carried out choledochectomy with hepaticojejunoanastomosis sec Roux and liver metastasis was destructed using radiofrequency ablation.
我们报告了一例罕见的透明细胞肾细胞癌转移至胆总管的病例。这是1966年至2010年MEDLINE数据库中列出的第9例。一名71岁女性于1986年因G1期肾癌接受了右肾切除术。2006年，她因右侧肾床复发再次接受手术。组织学检查再次证实为透明细胞肾细胞癌。目前，在S 4/5发现了新的肝转移。手术中，我们发现了首次描述的肝转移，以及另一个位于胆总管内生长的转移灶。术前，患者既没有胆道梗阻的临床症状，也没有实验室指标异常。即使腹部超声、声诺维、CT和全身PET检查均为阴性。我们进行了胆总管切除术，行Roux-en-Y肝管空肠吻合术，并使用射频消融破坏了肝转移灶。
