Oncology, Royal Berkshire Hospital, Reading, UK.
Oncology, Frimley Health NHS Foundation Trust, Frimley, UK.
BMJ Case Rep. 2020 Dec 10;13(12):e237941. doi: 10.1136/bcr-2020-237941.
A 70-year-old man presented with gradually worsening throat discomfort. He had no prior diagnosis of cancer and no travel history of note. Examination revealed a right-sided painless neck lump. He underwent an MRI of the neck, revealing a gadolinium-enhancing tonsillar mass and two brain lesions. Biopsy of the tonsil lesion was in keeping with an epithelial neoplasm, suggesting metastatic renal cell carcinoma. This was confirmed following a staging CT, which revealed a left renal mass and lung metastases. Due to his brain metastases, the patient has been started on the tyrosine kinase inhibitor cabozantinib. A brief discussion on the diagnostic evaluation of a tonsil mass as a rare presentation of renal cell cancer follows this report.
一位 70 岁男性因逐渐加重的咽喉不适就诊。他之前没有癌症的诊断，也没有显著的旅行史。检查发现右侧无痛性颈部肿块。他接受了颈部 MRI，显示增强的扁桃体肿块和两个脑部病变。扁桃体病变的活检符合上皮性肿瘤，提示转移性肾细胞癌。这一结果在分期 CT 后得到证实，该检查显示左侧肾肿块和肺转移。由于脑转移，该患者已开始使用酪氨酸激酶抑制剂卡博替尼治疗。在报告后，我们将简要讨论扁桃体肿块作为肾细胞癌罕见表现的诊断评估。
