Kesireddy Meghana, Correa Amit, Correa Raoul, Venkatesan Rohit
Internal Medicine, The University of Texas Medical Branch, Galveston, USA.
Oncology, The University of Texas Medical Branch, Galveston, USA.
Cureus. 2019 Jun 27;11(6):e5021. doi: 10.7759/cureus.5021.
Clear cell type renal carcinoma accounts for about 80% of all renal cell carcinomas. We present a 39-year-old male with clear cell renal carcinoma of the right kidney, stage I: T1 b (5 cm) N0 M0, who developed cutaneous metastases in the right submandibular region 28 months after nephrectomy. Our case is unique as i) the patient with stage I cancer (at the time of nephrectomy) presented with an isolated cutaneous nodule in a location distant from the primary site; ii) cutaneous nodule developed while being treated with pazopanib for metastatic lesions in the lung and adrenal; and iii) nivolumab and ipilimumab combination therapy decreased the vascularity of the nodule though it did not halt the nodule growth. Physicians should be knowledgeable about this rare clinical entity and its varied presentation. Further studies are necessary to determine optimal treatment, as the current therapeutic agents for metastatic renal carcinoma might not be adequate for cutaneous metastasis.
透明细胞型肾细胞癌约占所有肾细胞癌的80%。我们报告一名39岁男性，患有右肾透明细胞肾细胞癌，分期为I期：T1b（5厘米）N0M0，在肾切除术后28个月出现右下颌下区皮肤转移。我们的病例具有独特性，因为：i）该患者在肾切除时处于I期癌症，却在远离原发部位的位置出现孤立的皮肤结节；ii）在使用帕唑帕尼治疗肺和肾上腺转移病灶时出现皮肤结节；iii）纳武单抗和伊匹单抗联合治疗虽未阻止结节生长，但降低了结节的血管化程度。医生应了解这种罕见的临床实体及其多样的表现形式。由于目前用于转移性肾细胞癌的治疗药物可能对皮肤转移并不足够，因此需要进一步研究以确定最佳治疗方案。
