MacCraith Eoin, McCarthy Aoife, Swan Niall, Quinlan David
Department of Urology, St. Vincent's University Hospital, Dublin, Ireland.
Department of Pathology and Laboratory Medicine, St. Vincent's University Hospital, Dublin, Ireland.
BMJ Case Rep. 2017 Apr 22;2017:bcr-2016-218352. doi: 10.1136/bcr-2016-218352.
A 68-year-old woman presented with visible haematuria. Ultrasonography and triphasic CT revealed a 2.6 cm mass in the lower pole of the left kidney. A biopsy suggested low-grade renal cell carcinoma. Radical nephrectomy was performed and revealed an epithelioid angiomyolipoma. At year 3, the patient developed ductal carcinoma of the right breast and underwent a wide local excision and sentinel lymph node biopsy followed by chemotherapy and radiotherapy. 4 months later, she was noted to have a 1.6 cm nodule in the middle lobe of her right lung. The primary differential diagnosis was a breast cancer metastasis. Biopsy revealed a metastatic renal epithelioid angiomyolipoma. The patient elected to have stereotactic radiotherapy over surgical excision. Renal angiomyolipomata are generally regarded as benign tumours. In the present report, we describe the first case of pulmonary metastasis from renal epithelioid angiomyolipoma in the setting of breast cancer.
一名68岁女性因肉眼血尿就诊。超声检查和三期CT显示左肾下极有一个2.6厘米的肿块。活检提示为低级别肾细胞癌。遂行根治性肾切除术，结果显示为上皮样血管平滑肌脂肪瘤。在第3年，该患者发生了右乳导管癌，并接受了广泛局部切除和前哨淋巴结活检，随后进行了化疗和放疗。4个月后，发现她右肺中叶有一个1.6厘米的结节。主要鉴别诊断为乳腺癌转移。活检显示为转移性肾上皮样血管平滑肌脂肪瘤。患者选择立体定向放疗而非手术切除。肾血管平滑肌脂肪瘤通常被视为良性肿瘤。在本报告中，我们描述了首例在乳腺癌背景下肾上皮样血管平滑肌脂肪瘤发生肺转移的病例。
