Wang Gang, Zhou Chen, Villamil Carlos F, So Alan, Yuan Ren, English John C, Jones Edward C
Department of Pathology, BC Cancer Vancouver Centre, Vancouver, BC, Canada.
Department of Urology, Vancouver General Hospital, Vancouver, BC, Canada.
Case Rep Pathol. 2020 Mar 2;2020:9394680. doi: 10.1155/2020/9394680. eCollection 2020.
The testicular spread of renal cell carcinoma is extremely rare. Five cases of renal cell carcinoma metastatic to the testis are described. The patients ranged from 45 to 81 years of age. Four of the five patients had known renal cell carcinoma. The time intervals between the partial and radical nephrectomies for the primary kidney tumors and the occurrence of testicular metastases ranged from 29 to 34 months. In one patient, the testicular mass was the initial presentation leading to a diagnosis of renal cell carcinoma. There were three ipsilateral metastases, one contralateral metastasis, and one bilateral metastasis. The metastatic deposits ranged in size from 2.0 to 5.7 cm. One case had multiple metastatic tumor nodules. All of the metastatic tumors had clear cell histological features, microscopically concordant with the primary renal cell carcinoma subtype. Three patients died of the disease 17 to 42 months after orchiectomy. One patient is alive with additional metastatic lesions 13 months after orchiectomy. One patient had been free of disease at 87 months after orchiectomy but is now on targeted therapy for an additional metastasis at 93 months after orchiectomy. To date, this report is one of the largest single series of patients with renal cell carcinoma metastatic to the testis, and it has the longest follow-up and survival among all the reported cases.
肾细胞癌的睾丸转移极为罕见。本文描述了5例肾细胞癌转移至睾丸的病例。患者年龄在45岁至81岁之间。5例患者中有4例已知患有肾细胞癌。原发性肾肿瘤行部分或根治性肾切除与睾丸转移发生之间的时间间隔为29至34个月。1例患者以睾丸肿块为首发表现，最终诊断为肾细胞癌。有3例同侧转移、1例对侧转移和1例双侧转移。转移灶大小为2.0至5.7厘米。1例有多个转移瘤结节。所有转移瘤在显微镜下均具有透明细胞组织学特征，与原发性肾细胞癌亚型一致。3例患者在睾丸切除术后17至42个月死于该疾病。1例患者在睾丸切除术后13个月仍存活，但有其他转移病灶。1例患者在睾丸切除术后87个月无疾病，但在睾丸切除术后93个月因出现新的转移灶而接受靶向治疗。迄今为止，本报告是肾细胞癌转移至睾丸的最大单组病例系列之一，并且在所有报告病例中随访时间最长、生存时间最长。
