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酷似原发性肾肿瘤的食管鳞状细胞癌孤立性肾转移——病例报告及文献复习

Solitary renal metastasis of esophageal squamous cell carcinoma mimicking primary renal neoplasm - A case report and literature review.

作者信息

Chang Kai-Po, Huang Chi-Ping, Chang Han

机构信息

Department of Pathology, China Medical University Hospital, 404, Taichung, Taiwan.

Department of Urology, China Medical University Hospital, 404, Taichung, Taiwan.

出版信息

Biomedicine (Taipei). 2016 Mar;6(1):6. doi: 10.7603/s40681-016-0006-4. Epub 2016 Feb 10.

Abstract

Solitary renal metastasis of esophageal cancer is rare clinically, with only 14 cases being reported in the literature. The authors here report a case of a 53-year-old man with a metachronous hypopharyngeal and esophageal squamous cell carcinoma who developed a solitary renal metastasis after complete chemoradiotherapy for esophageal cancer, and subsequently received a left nephrectomy. The metastatic esophageal cancer was indistinguishable from primary renal neoplasm in the computed tomography but showed the histopathologic characteristic of esophageal cancer in directly invading the renal artery, and the tumor spreading in the kidney. The patient died of pneumonia two months after diagnosis. Among the previous 14 reported cases, 12 occurred in Asians, and their overall survival time ranges from two months to nine years after nephrectomy, either with or without adjuvant chemotherapy. Accordingly, a solitary renal mass in patients with a history of esophageal cancer is warranted to differentiate metastatic esophageal cancer from primary renal neoplasm, and a reliable therapy needs to be planned early for improving the patient's chance of survival.

摘要

食管癌孤立性肾转移在临床上较为罕见,文献中仅报道了14例。本文作者报告了1例53岁男性患者,患有异时性下咽和食管鳞状细胞癌,在食管癌接受完整放化疗后出现孤立性肾转移,随后接受了左肾切除术。转移性食管癌在计算机断层扫描中与原发性肾肿瘤难以区分,但在组织病理学上表现出食管癌直接侵犯肾动脉以及肿瘤在肾内播散的特征。该患者在诊断后两个月死于肺炎。在之前报道的14例病例中,12例发生在亚洲人身上,肾切除术后其总生存时间为两个月至九年,无论是否接受辅助化疗。因此,有食管癌病史的患者出现孤立性肾肿块时,有必要鉴别转移性食管癌与原发性肾肿瘤,并尽早制定可靠的治疗方案以提高患者的生存机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2405/4752552/41da61b463d4/40681_2016_6_Fig1_HTML.jpg

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