Honda-Takinami Ruriko, Ishibashi Kei, Onagi Akifumi, Tanji Ryo, Matsuoka Kanako, Hoshi Seiji, Koguchi Tomoyuki, Hata Junya, Yabe Michihiro, Sato Yuichi, Akaihata Hidenori, Kataoka Masao, Ogawa Soichiro, Haga Nobuhiro, Kojima Yoshiyuki
Department of Urology Fukushima Medical University School of Medicine Fukushima Japan.
IJU Case Rep. 2020 Jan 10;3(2):36-39. doi: 10.1002/iju5.12135. eCollection 2020 Mar.
Chromophobe renal cell carcinoma presents in early pathological stages with a lower risk of metastasis. However, aggressive features and metastasis can occur. A rare case of rapidly progressive disease with histological changes is presented.
A 56-year-old woman had a right renal tumor with multiple lymph node metastases, and the pathological diagnosis of the biopsy specimens from the primary tumor was chromophobe renal cell carcinoma. After sunitinib treatment, the metastatic lymph node had decreased in size and the numbers of circulating tumor cells were decreased, consequently, cytoreductive nephrectomy was performed. However, rapid progression of lymph node metastases was observed. Histopathological examination showed that the renal tumor was diagnosed as spindle cell renal carcinoma.
It appears that the primary tumor underwent epithelial-mesenchymal transition; further tissue specimen collection and analysis might be needed.
嫌色性肾细胞癌多在病理早期出现，转移风险较低。然而，也可能出现侵袭性特征和转移情况。本文报告一例罕见的具有组织学变化的快速进展性疾病病例。
一名56岁女性患有右肾肿瘤并伴有多处淋巴结转移，原发肿瘤活检标本的病理诊断为嫌色性肾细胞癌。舒尼替尼治疗后，转移淋巴结缩小，循环肿瘤细胞数量减少，因此进行了减瘤性肾切除术。然而，观察到淋巴结转移迅速进展。组织病理学检查显示，肾肿瘤被诊断为梭形细胞肾癌。
原发肿瘤似乎发生了上皮-间质转化；可能需要进一步收集和分析组织标本。
