Mandal Adhip, Littler Yvonne, Libertiny Gabor
Department of General Surgery, Northampton General Hospital, Northampton, UK.
BMJ Case Rep. 2012 Jun 8;2012:bcr0220125764. doi: 10.1136/bcr.02.2012.5764.
Renal cell carcinoma is known to have blood-borne metastasis. This is usually to the bone, lungs and brain. Other unusual metastatic presentations such as skin and bowel metastasis have also been described. In most cases, the metastasis occurs as a late manifestation in a patient with known primary renal cell carcinoma. A rare synchronous presentation of skin and duodenal metastasis in an otherwise asymptomatic patient is reported here. This patient presented with a skin lesion that, on excision, brought up the diagnosis of metastatic renal cell carcinoma. While the patient was waiting for surgery, she also developed melena that, on gastroscopy, confirmed a duodenal metastasis. This case highlights the importance of early recognition of otherwise unrelated lesions as presentations for an advanced renal malignancy.
肾细胞癌已知会发生血行转移。这种转移通常发生至骨、肺和脑。也有其他不常见的转移表现，如皮肤和肠道转移的报道。在大多数情况下，转移是已知原发性肾细胞癌患者的晚期表现。本文报道了一例罕见的在无症状患者中皮肤和十二指肠转移的同步表现。该患者出现皮肤病变，切除后诊断为转移性肾细胞癌。在患者等待手术期间，她还出现了黑便，胃镜检查证实为十二指肠转移。该病例强调了早期识别原本不相关的病变作为晚期肾恶性肿瘤表现的重要性。
