Shinohara Masatake, Hosokawa Yukinari, Iida Kouta, Takenaga Maho, Itami Yoshitaka, Hayashi Yoshiki, Fujimoto Kiyohide
The Department of Urology, Tane General Hospital.
The Department of Urology, Nara Medical University.
Hinyokika Kiyo. 2014 May;60(5):231-5.
Case 1 : A 60-year-old man presented with right flank pain. A computed tomography (CT) scan revealed a large right renal tumor, multiple lung metastases, multiple liver metastases, and tumor thrombus of the right renal vein. These findings were strongly suggestive of renal cell carcinoma. The patient suddenly complained of dyspnea at night due to bilateral pulmonary embolism, and the patient died 11 days after onset. Needle necropsy showed that the tumors were squamous cell carcinomas of the renal pelvis. Case 2 : A 66-year-old man presented with macrohematuria. An abdominal CT scan revealed a right renal mass and liver metastasis. The differential diagnosis was between renal cell carcinoma and urothelial carcinoma. A renal biopsy revealed urothelial carcinoma of the renal pelvis. The patient died of the disease 3 months after initiation of chemotherapy with gemcitabine and cisplatin. We report these 2 cases to emphasize the importance of renal biopsy and thorough histological analysis for the determination of treatment strategies against unresectable renal tumors.
病例1：一名60岁男性因右侧胁腹疼痛就诊。计算机断层扫描（CT）显示右肾有一个大肿瘤，伴有多发肺转移、多发肝转移以及右肾静脉肿瘤血栓形成。这些表现强烈提示为肾细胞癌。患者因双侧肺栓塞突然在夜间出现呼吸困难，发病11天后死亡。针吸尸检显示肿瘤为肾盂鳞状细胞癌。病例2：一名66岁男性出现肉眼血尿。腹部CT扫描显示右肾肿块及肝转移。鉴别诊断考虑肾细胞癌和尿路上皮癌。肾活检显示为肾盂尿路上皮癌。患者在接受吉西他滨和顺铂化疗3个月后死于该疾病。我们报告这2例病例，以强调肾活检及全面组织学分析对于确定不可切除性肾肿瘤治疗策略的重要性。
