Kongnyuy Michael, Lawindy Samuel, Martinez Daniel, Parker Justin, Hall Mary
University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA.
University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA; James A. Haley Veterans' Hospital, Tampa, FL 33612, USA.
Case Rep Urol. 2016;2016:1829025. doi: 10.1155/2016/1829025. Epub 2016 Jan 21.
We describe the rare case of a 68-year-old gentleman with the history of a hand-assisted laparoscopic left radical nephrectomy for a T2bN0M1 clear cell renal cell carcinoma (RCC). Seven years after surgery and with clean surveillance imaging for metastasis/recurrence the patient presented with three separate tumors suspicious for malignancy. A bladder lesion was found during workup for hematuria, a stomach lesion during diagnostic endoscopy, and a testicular lesion during self-exam. He underwent transurethral resection of bladder tumor, left inguinal orchiectomy, and upper endoscopic ensnarement. All specimens surprisingly showed RCC by histology and immunostaining. These three sites are rare for RCC metastasis and simultaneous presentation is even rarer, further emphasizing the importance of continuous and careful follow-up in this patient population, despite what could appear as complete remission.
我们描述了一例罕见病例，一名68岁男性，有因T2bN0M1期透明细胞肾细胞癌（RCC）接受手辅助腹腔镜下左肾根治性切除术的病史。术后七年，其转移/复发监测影像检查结果正常，但患者出现了三个疑似恶性肿瘤的独立病灶。在血尿检查过程中发现膀胱病变，诊断性内镜检查时发现胃部病变，自我检查时发现睾丸病变。他接受了经尿道膀胱肿瘤切除术、左侧腹股沟睾丸切除术和上消化道内镜圈套切除术。所有标本经组织学和免疫染色检查，令人惊讶地均显示为肾细胞癌。这三个部位发生肾细胞癌转移罕见，同时出现则更为罕见，这进一步强调了对该患者群体进行持续、仔细随访的重要性，尽管看似已完全缓解。
