Raiss Hanan, Duplomb Sophie, Tartas Sophie, Layachi Mohamed, Errihani Hassan
Service d'Oncologie Médicale, Institut National d'Oncologie, CHU Rabat and Université Mohamed V, Avenue Allal Al Fassi, Madinat Al Irfane, 10000, Rabat, Morocco.
Institut de Cancérologie, Hospices Civils de Lyon and Université de Lyon, 165, Chemin du Grand Revoyet, 69495, Pierre-Bénite cedex, France.
J Med Case Rep. 2017 Nov 7;11(1):314. doi: 10.1186/s13256-017-1470-5.
Renal cell carcinoma is the third most common tumor that metastasizes to the head and neck, after breast and lung carcinomas. Tongue metastasis as an initial presentation of renal cell carcinoma is extremely rare, and very few cases have been reported. The prognosis is poor. We present a rare case of metastatic renal cell carcinoma that initially presented as a tongue lesion.
We report the case of a 55-year-old white man who presented with a large exophytic lesion on his tongue. A biopsy was taken, and pathologic examination showed a poorly differentiated carcinoma including a sarcomatoid component. Subtotal glossectomy with neck dissection were planned, but a positron emission tomographic-computed tomography scan showed a left kidney mass. Immunohistochemical evaluation of the tongue lesion was performed, and it was compatible with metastasis from primary renal cell carcinoma. The biopsy of the renal lesion showed a high-grade unclassified renal cell carcinoma. Although our patient underwent systemic therapy, he died of hemorrhagic complications 3 months after the initiation of therapy.
Tongue lesions require a complete assessment to distinguish a metastasis from a primary cancer in order to give the appropriate treatment.
肾细胞癌是继乳腺癌和肺癌之后第三常见的转移至头颈部的肿瘤。以舌部转移作为肾细胞癌的首发表现极为罕见，仅有少数病例报道。其预后较差。我们报告一例罕见的转移性肾细胞癌，最初表现为舌部病变。
我们报道一名55岁白人男性，其舌部出现一个巨大的外生性病变。进行了活检，病理检查显示为低分化癌，包括肉瘤样成分。计划行舌次全切除术及颈部清扫术，但正电子发射断层扫描计算机断层扫描显示左肾有肿块。对舌部病变进行了免疫组化评估，结果与原发性肾细胞癌转移相符。肾部病变活检显示为高级别未分类肾细胞癌。尽管我们的患者接受了全身治疗，但在治疗开始3个月后死于出血并发症。
舌部病变需要进行全面评估，以区分转移癌与原发性癌症，从而给予适当的治疗。
