Makino Yuki, Tsuchihashi Kazunari, Shimizu Yosuke, Kanamaru Sojun, Hashimoto Kimio, Ito Noriyuki
The Department of Urology, Nishi-Kobe Medical Center.
The Department of Pathology, Nishi-Kobe Medical Center.
Hinyokika Kiyo. 2016 Jul;62(7):349-53. doi: 10.14989/ActaUrolJap_62_7_349.
A 59-year-old man who had undergone hemodialysis for 13 years was diagnosed with left renal cell carcinoma (RCC),cT1aN0M0,in 2010. He had a laparoscopic left nephrectomy,and the pathological diagnosis at that time was clear cell carcinoma,pT1a (multifocal). At 1 year after surgery,he was diagnosed with a left renal hilar lymph node metastasis and a new right RCC,cT1aN0M0. Consequently,he underwent a right nephrectomy and retroperitoneal lymph node dissection in 2012. Pathologic diagnosis by the current classification of the right renal tumor was acquired cystic disease-associated renal cell carcinoma (ACD-associated RCC),and that of the left hilar lymph node was metastatic RCC with sarcomatoid change. According to the revised classification the pathological diagnosis of the left renal tumor was ACD-associated RCC. There has been no evidence of recurrence or metastasis for 3 years after the second operation. The specific classification of dialysis-related renal tumors and their characteristics should be standard knowledge for urologists.
一名接受了13年血液透析的59岁男性在2010年被诊断为左肾细胞癌（RCC），cT1aN0M0。他接受了腹腔镜左肾切除术，当时的病理诊断为透明细胞癌，pT1a（多灶性）。术后1年，他被诊断为左肾门淋巴结转移和新发右肾RCC，cT1aN0M0。因此，他于2012年接受了右肾切除术和腹膜后淋巴结清扫术。根据当前右肾肿瘤分类，病理诊断为获得性囊性疾病相关性肾细胞癌（ACD相关性RCC），左肾门淋巴结的病理诊断为伴有肉瘤样改变的转移性RCC。根据修订后的分类，左肾肿瘤的病理诊断为ACD相关性RCC。第二次手术后3年没有复发或转移的证据。透析相关肾肿瘤的具体分类及其特征应为泌尿外科医生的标准知识。
