Kidd Laura C, Okoro Chinonyerem, Kamat Bhishak, Peter Anu, Patel Pratik, Reese Adam C
Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.
Department of Radiology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.
J Endourol Case Rep. 2020 Dec 29;6(4):512-515. doi: 10.1089/cren.2020.0168. eCollection 2020.
Renal mass biopsy (RMB) is an increasingly utilized modality in the work-up of patients with suspicious renal masses. Recurrence of renal cell carcinoma (RCC) from biopsy tract seeding is exceedingly rare in the literature. We report a case of such a phenomenon. Our patient is a 75-year-old Caucasian man and former smoker with a functionally solitary left kidney, initially worked up for gross hematuria and left flank pain. Imaging revealed hydronephrosis and a left renal mass, which was biopsied. Pathology analysis demonstrated clear cell RCC, and a left robotic radical nephrectomy was performed with negative surgical margins. Sixteen months postoperatively, imaging revealed multiple small masses along the biopsy tract, suspicious for recurrence. These were biopsied and pathology analysis confirmed recurrent clear cell RCC. Despite its rarity, biopsy tract seeding is a serious complication of RMB. This warrants thorough counseling and shared decision making between providers and all patients with renal masses planning to undergo a RMB.
肾肿物活检（RMB）在可疑肾肿物患者的检查中应用越来越广泛。文献中，经活检通道种植导致肾细胞癌（RCC）复发的情况极为罕见。我们报告了这样一例病例。我们的患者是一名75岁的白种男性，既往吸烟，左肾为功能性孤立肾，最初因肉眼血尿和左侧腰痛接受检查。影像学检查显示肾积水和左肾肿物，遂进行了活检。病理分析显示为透明细胞RCC，并进行了左侧机器人辅助根治性肾切除术，手术切缘阴性。术后16个月，影像学检查显示沿活检通道有多个小肿物，怀疑为复发。对这些肿物进行了活检，病理分析证实为复发性透明细胞RCC。尽管这种情况罕见，但活检通道种植是RMB的一种严重并发症。这需要医生对所有计划接受RMB的肾肿物患者进行全面的咨询并共同做出决策。
