Kessoku Hisashi, Yoshimura Tsuyoshi, Iino Takashi, Tanaka Yasuhiro
Department of Otorhinolaryngology, Dokkyo Medical University Koshigaya Hospital, Koshigaya.
Nihon Jibiinkoka Gakkai Kaiho. 2014 Jan;117(1):46-51. doi: 10.3950/jibiinkoka.117.46.
In January 2011, a 64-year-old woman who had undergone tumor resection for pleomorphic adenoma of the left parotid gland four times since her first operation in 1996 visited an orthopedist in our hospital complaining of pain in her right lower limb. Computed tomography (CT) of the whole body showed multiple tumors on the left parotid gland, right kidney, the sacrum, and both lungs. Biopsy of the sacral region and right nephrectomy were performed based on a clinical diagnosis of sacral and pulmonary metastases from renal cell carcinoma, and palliative radiation therapy was immediately begun on the sacral region. Given the definitive pathological diagnosis of metastasis of pleomorphic adenoma of the parotid gland, the recurrent tumor of the left parotid gland and the surrounding lymph nodes were first removed. Postoperative findings demonstrated that the pleomorphic adenoma had metastasized to the lymph nodes. The lung tumors were resected subsequently, and postoperative findings led to the diagnosis of pleomorphic adenoma. Metastasis of pleomorphic adenoma is known to be extremely rare, and to our knowledge this case of metastasis to a kidney is the first reported in Japan.
2011年1月，一名64岁女性因右下肢疼痛前来我院骨科就诊。该患者自1996年首次手术以来，已因左腮腺多形性腺瘤接受了4次肿瘤切除术。全身计算机断层扫描（CT）显示左腮腺、右肾、骶骨和双肺均有多处肿瘤。基于肾细胞癌骶骨和肺转移的临床诊断，进行了骶骨区域活检和右肾切除术，并立即对骶骨区域进行了姑息性放射治疗。鉴于腮腺多形性腺瘤转移的明确病理诊断，首先切除了左腮腺复发肿瘤及周围淋巴结。术后结果显示多形性腺瘤已转移至淋巴结。随后切除了肺部肿瘤，术后结果确诊为多形性腺瘤。多形性腺瘤转移极为罕见，据我们所知，这例转移至肾脏的病例是日本首例报道。
