Olaniran Kabir, Cheng Waina, Pulinthanathu Rajiv
Department of Medicine, Lincoln Medical and Mental Health Center, Bronx, NY, U.S.A.
Am J Case Rep. 2014 Jun 14;15:254-7. doi: 10.12659/AJCR.890424. eCollection 2014.
Female, 20 FINAL DIAGNOSIS: Papillary renal cell carcinoma Symptoms: Hemopthysis Medication: Sutent Clinical Procedure: CT guided biopsy Specialty: Oncology.
Rare disease.
Papillary renal cell carcinoma (PRCC) is a rare disease and is a carcinoma of the renal tubular epithelium, comprising only 10-15% of all renal cell carcinoma cases. The majority of cases occur in the sixth decade of life. PRCC rarely occurs before the fourth decade in the absence of family history. This paper describes an aggressive, sporadic case of PRCC in a 20-year-old female without family history and no risk factors.
A 20-year-old African American female was admitted for hemoptysis with elevated blood pressure and was found to have left peri-hilar opacification on chest X-ray. Further radiological studies led to the discovery of a large complex left renal lesion within the collecting system, infiltrating the renal artery and causing severe hydronephrosis with para-aortic lymphadenopathy. An MRI also showed signal heterogeneity in the L2 and L3 vertebrae. Biopsies of the left renal mass and a right endobronchial lesion confirmed metastatic PRCC. Treatment was commenced with a tyrosine kinase inhibitor. Within a few weeks, the vertebral metastatic lesions progressed to cause spinal compression. After targeted radiotherapy, the patient was referred to Memorial Sloan Kettering Cancer Center for enrolment in a clinical trial.
PRCC rarely occurs in the second decade of life and even then, most such early cases occur in family clusters. PRCC also has a relatively benign course, constituting less than 10% of all metastatic renal cell carcinomas, further making this case a unique presentation.
女性，20岁 最终诊断：乳头状肾细胞癌 症状：咯血 用药：索坦 临床操作：CT引导下活检 专科：肿瘤学
罕见疾病
乳头状肾细胞癌（PRCC）是一种罕见疾病，是肾小管上皮的癌症，仅占所有肾细胞癌病例的10%-15%。大多数病例发生在生命的第六个十年。在没有家族史的情况下，PRCC很少在第四个十年之前发生。本文描述了一例侵袭性、散发性PRCC病例，患者为一名20岁女性，无家族史且无危险因素。
一名20岁非裔美国女性因咯血伴血压升高入院，胸部X线检查发现左肺门周围模糊影。进一步的放射学检查发现左肾集合系统内有一个大的复杂病变，侵犯肾动脉，导致严重肾积水伴主动脉旁淋巴结肿大。MRI还显示L2和L3椎体信号不均匀。左肾肿块和右支气管内病变的活检证实为转移性PRCC。开始使用酪氨酸激酶抑制剂治疗。几周内，椎体转移灶进展导致脊髓受压。经过靶向放疗后，患者被转诊至纪念斯隆凯特琳癌症中心参加一项临床试验。
PRCC很少发生在生命的第二个十年，即便如此，大多数此类早期病例发生在家族聚集性病例中。PRCC的病程也相对良性，在所有转移性肾细胞癌中占比不到10%，这进一步使得该病例表现独特。
