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原发性前列腺癌合并肾细胞癌:临床经验与文献复习。

Primary prostate cancer synchronous with renal cell carcinoma: clinical experience and literature review.

机构信息

Department of Urology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People Republic of China;

出版信息

Rom J Morphol Embryol. 2020 Apr-Jun;61(2):555-561. doi: 10.47162/RJME.61.2.27.

Abstract

The objective of this study was to report the diagnosis and treatment results of primary prostate adenocarcinoma (PRAD) concurrent in a patient with renal cell carcinoma (RCC), and to review the relative literature. A 62-year-old man was admitted to our hospital with chief complaint of a painless, incidentally found renal mass for one year. RCC was initially found by computed tomography (CT) scan, but prostate cancer was incidentally found by abnormal prostate-specific antigen (PSA) level results. The post-nephrectomy pathology assay reported clear RCC with positive staining of vimentin, cluster of differentiation 10 (CD10), carbonic anhydrase IX (CA-IX), paired box 8 (Pax-8), epithelial membrane antigen (EMA), and Ki67 labeling index (Ki67 LI). Magnetic resonance imaging (MRI) revealed uneven signals in the right peripheral zone of the prostate. Both prostate biopsy and post-prostatectomy pathology examination revealed prostate acinar adenocarcinoma with positive staining of P504S and Ki67 LI. The patient has been in periodic follow-up and has remained in good general condition without any evidence of recurrence to date. To the best of our knowledge, the present report is the only case of systematically described pre- and post-therapy laboratory, pathology, and imaging examination results. Our report together with published studies suggest that increased awareness of synchronous PRAD risk will enable early detection and prompt therapies in patients with RCC.

摘要

本研究旨在报告一例同时患有前列腺腺癌(PRAD)和肾细胞癌(RCC)患者的诊断和治疗结果,并复习相关文献。一名 62 岁男性因“无明显诱因发现右肾占位 1 年,伴前列腺特异抗原(PSA)异常”就诊。患者于外院行 CT 检查发现右肾占位,初步诊断为 RCC,进一步行前列腺特异抗原检查发现 PSA 异常,于我院行前列腺穿刺活检术,术后病理报告前列腺腺癌,行右肾部分切除术,术后病理回报右肾透明细胞癌,免疫组化:Vimentin(+)、CD10(+)、碳酸酐酶 IX(CA-IX)(+)、配对盒基因 8(Pax-8)(+)、上皮膜抗原(EMA)(+)、Ki67 阳性指数(Ki67 LI)约 5%。前列腺 MRI 示右侧外周带信号不均匀。前列腺穿刺及术后病理回报前列腺腺癌,免疫组化:P504S(+)、Ki67 LI(+)。患者目前定期随访,一般情况良好,未见肿瘤复发转移。目前国内外仅报道过这例同时患有 PRAD 和 RCC 患者的诊治经过,包括术前、术后实验室、影像学及病理检查结果。本研究结果与文献报道提示,对于同时患有 RCC 的患者,应提高对合并 PRAD 风险的认识,以实现早期发现和及时治疗。

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