Azuma T, Koide A, Asami H, Kuroda M, Yano H, Honda E, Senga M, Hoonoki S
Dept. of Surgery, Ueno City Hospital.
Gan No Rinsho. 1990 Dec;36(15):2605-9.
In line with an increase in the incidence of multiple primary cancers, we have encountered a case of synchronous multiple primary cancers of the stomach and the left kidney. The patient, a 69-year-old male, visited our hospital after experiencing epigastric discomfort for three months. An advanced gastric cancer, Borrmann III type, was detected by endoscopic examination. Preoperative abdominal computed tomography also revealed a large low density mass occupying the upper part of the left kidney. On angiography, the left kidney showed a hypervascular mass, showing pooling and tumoral stains, thereby suggesting a renal cell carcinoma. The patient thus underwent a subtotal gastrectomy with an R2 lymph node dissection and a left radical nephrectomy. Histologically, the gastric lesion was a poorly-differentiated adenocarcinoma and the left renal lesion was a renal cell carcinoma of the clear cell type.
随着多原发性癌症发病率的上升,我们遇到了一例胃和左肾同步多原发性癌症的病例。患者为一名69岁男性,在经历了三个月的上腹部不适后前来我院就诊。内镜检查发现进展期胃癌,Borrmann III型。术前腹部计算机断层扫描还显示左肾上部有一个巨大的低密度肿块。血管造影显示左肾有一个高血运肿块,有造影剂积聚和肿瘤染色,提示为肾细胞癌。因此,该患者接受了R2淋巴结清扫的胃次全切除术和左肾癌根治术。组织学检查显示,胃部病变为低分化腺癌,左肾病变为透明细胞型肾细胞癌。