Nakadai Jumpei, Ide Hiroki, Hirasawa Yosuke, Ito Yujiro, Uchida Yasumitsu, Masuda Takeshi
Department of Urology, Saitama Municipal Hospital, Midoriku, Saitama, Japan.
Can Urol Assoc J. 2013 May-Jun;7(5-6):E344-6. doi: 10.5489/cuaj.988.
A 78-year-old man was admitted to the Department of Otolaryngology of our hospital with bilateral lymph node swelling of the neck. Pathological examination revealed squamous cell carcinoma (SCC). He underwent computed tomography (CT) of the neck and chest, upper gastrointestinal endoscopy and laryngoscopy to locate a primary tumour, however, no obvious tumour was detected. Eight months later, a renal tumour without regional lymph node swelling was found when a chest CT scan was performed again. We then performed a right nephroureterectomy and regional lymphadenectomy. Pathological examination revealed SCC of the renal pelvis, pT3, grade 3, without regional lymph node metastasis. This pathological finding for the kidney was virtually the same as that for cervical lymph nodes. Therefore, it was thought that his cervical tumours had metastasized from the renal pelvic SCC. To the best of our knowledge, there are no reports of renal pelvic carcinoma without regional lymph node metastasis having only cervical lymph node metastasis. This is the first case of isolated cervical lymph node metastasis from renal pelvic SCC.
一名78岁男性因双侧颈部淋巴结肿大入住我院耳鼻喉科。病理检查显示为鳞状细胞癌(SCC)。他接受了颈部和胸部的计算机断层扫描(CT)、上消化道内镜检查和喉镜检查以定位原发肿瘤,但未检测到明显肿瘤。八个月后,再次进行胸部CT扫描时发现了一个无区域淋巴结肿大的肾肿瘤。随后我们进行了右肾输尿管切除术和区域淋巴结清扫术。病理检查显示为肾盂鳞状细胞癌,pT3,3级,无区域淋巴结转移。肾脏的这一病理发现与颈部淋巴结的几乎相同。因此,认为他的颈部肿瘤是由肾盂鳞状细胞癌转移而来。据我们所知,尚无仅发生颈部淋巴结转移而无区域淋巴结转移的肾盂癌的报道。这是首例肾盂鳞状细胞癌孤立性颈部淋巴结转移病例。