Gong Guanghui, Lin Ting, Yuan Yishu, Li Yulai, Liu Ruijie
Department of Pathology, Xiangya Hospital, Central South University.
Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University.
Medicine (Baltimore). 2019 Jan;98(4):e14236. doi: 10.1097/MD.0000000000014236.
Collecting duct carcinoma (CDC) is a rare neoplasm arising from the collecting duct and should be distinguished from other renal cell carcinomas that mostly originated from the proximal tubular epithelium and tumors originated from the urothelium. It usually occurs in unilateral kidney, sometimes found with cystic change.
We present the case of a 53-year-old male suffering from repeated bilateral flank pain for 6 months, increased pain with dysuria for 5 days.
Ultrasound showed 2 similar hybrid echo masses in bilateral kidneys with enlarged lymph nodes surrounded, which accords with magnetic resonance imaging (MRI), and intraoperative biopsy reported malignancy.
An exploratory operation was performed and the mass on the left kidney was removed, but pathological result reported collecting duct carcinoma according to the morphological features and immunohistochemical tests. Also postsurgery positron emission tomography-computed tomography (PET-CT) confirmed the mass on the left kidney is also a lesion of CDC.
The patient refused chemotherapy and had an overall survival of 7 months.
We presented a case of CDC involving bilateral kidneys with cystic change; this is the first case of bilateral renal occurrence with cystic change to our knowledge. Because of CDC's rapid growth and the lack of effective adjuvant treatment after surgery, the prognosis is poor and the diagnosis should be made carefully.
集合管癌(CDC)是一种起源于集合管的罕见肿瘤,应与大多数起源于近端肾小管上皮的其他肾细胞癌以及起源于尿路上皮的肿瘤相鉴别。它通常发生在单侧肾脏,有时伴有囊性改变。
我们报告一例53岁男性,反复双侧胁腹疼痛6个月,疼痛加重伴排尿困难5天。
超声显示双侧肾脏有2个类似的混合回声肿块,周围淋巴结肿大,这与磁共振成像(MRI)结果相符,术中活检报告为恶性。
进行了探查手术,切除了左肾肿块,但病理结果根据形态学特征和免疫组化检查报告为集合管癌。术后正电子发射断层扫描-计算机断层扫描(PET-CT)也证实左肾肿块也是一例集合管癌病变。
患者拒绝化疗,总生存期为7个月。
我们报告了一例双侧肾脏发生且伴有囊性改变的集合管癌病例;据我们所知,这是首例双侧肾脏发生且伴有囊性改变的病例。由于集合管癌生长迅速且术后缺乏有效的辅助治疗,预后较差,诊断时应谨慎。