Pascoe Claire, Christidis Daniel, Clouston David, Lawrentschuk Nathan
Department of Urology, Austin Health, Heidelberg, Victoria, Australia.
YURO, Young Urology Researchers Organisation, Melbourne, VIC, Australia.
BMJ Case Rep. 2018 Apr 21;2018:bcr-2017-223423. doi: 10.1136/bcr-2017-223423.
Renal cell carcinoma is historically known as the 'great masquerader' with 40% of patients experiencing a paraneoplastic syndrome. Translocation carcinoma represents one-third of renal cancer in paediatric patients but less than 3% of renal cancers in patients aged 18-45 years where the clinical course is often rapidly terminal. There are less than 10 reported cases of leucoclastic vasculitis associated with clear cell carcinoma reported in the literature and 10 case reports of translocation carcinoma in adults. To our knowledge, we present the first reported case of Xp11 translocation carcinoma presenting as cutaneous vasculitis, as part of a paraneoplastic syndrome, in an adult patient. Our case highlights that renal cell cancers are truly the 'great masquerader' and a rash can be the first sign of renal malignancy.
肾细胞癌历来被称为“伪装大师”，40%的患者会出现副肿瘤综合征。易位癌在儿科患者的肾癌中占三分之一，但在18至45岁患者的肾癌中占比不到3%，其临床病程通常进展迅速，往往是终末期。文献报道中与透明细胞癌相关的白细胞破碎性血管炎病例不到10例，成人易位癌的病例报告有10例。据我们所知，我们报告了首例在成年患者中表现为皮肤血管炎的Xp11易位癌病例，该血管炎是副肿瘤综合征的一部分。我们的病例突出表明，肾细胞癌确实是“伪装大师”，皮疹可能是肾恶性肿瘤的首发症状。
