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肾细胞癌的胃转移真的罕见吗?一例病例报告及文献系统综述。

Are gastric metastases of renal cell carcinoma really rare? A case report and systematic review of the literature.

作者信息

Prudhomme Thomas, Maulat Charlotte, Péré Guillaume, Mokrane Fatima-Zohra, Soulié Michel, Muscari Fabrice

机构信息

Department of Digestive Surgery, Toulouse University Hospital, 31059, Toulouse, France; Department of Urology and Kidney Transplantation, Toulouse University Hospital, 31059, Toulouse, France.

Department of Digestive Surgery, Toulouse University Hospital, 31059, Toulouse, France.

出版信息

Int J Surg Case Rep. 2021 May;82:105867. doi: 10.1016/j.ijscr.2021.105867. Epub 2021 Apr 6.

Abstract

INTRODUCTION

Renal cell carcinoma (RCC) represents above 3 % of all cancers. At diagnosis, above 25 % of patients with RCC present an advanced disease. Gastric metastasis of RCC is associated with poor outcome. We report the case of a patient treated for a gastric metastasis of RCC and we conducted a systematic review of the literature to report all published cases of RCC patients with gastric metastasis.

CASE PRESENTATION

In December 2010, a 61-year-old man was treated by open partial nephrectomy for a localized right clear cell RCC. In September 2018, a metachronous gastric metastasis was found on CT scan. The lesion was located on the lesser curvature of the stomach, measuring 4.5 cm long axis. No other secondary lesions were identified. A laparoscopic wedge resection, converted to laparotomy was performed. Two years later, in September 2020, a CT scan was performed, revealing a 17 mm adenopathy behind the hepatic hilum and a surgical management was performed, including a lymph node dissection of the hepatic hilum and the hepatic artery. Actually, he remains healthy.

CLINICAL DISCUSSION AND CONCLUSION

Our systematic review suggests that solitary gastric metastasis of RCC are scarce. In comparison of patients with multiple metastatic sites, the median survival of patients with solitary gastric metastasis is longer.

摘要

引言

肾细胞癌(RCC)占所有癌症的3%以上。在确诊时,超过25%的RCC患者已处于晚期疾病阶段。RCC的胃转移与不良预后相关。我们报告了一例接受RCC胃转移治疗的患者,并对文献进行了系统回顾,以报告所有已发表的RCC胃转移患者病例。

病例介绍

2010年12月,一名61岁男性因局限性右肾透明细胞RCC接受了开放性部分肾切除术。2018年9月,CT扫描发现异时性胃转移。病变位于胃小弯处,长轴为4.5厘米。未发现其他继发性病变。进行了腹腔镜楔形切除术,后转为开腹手术。两年后的2020年9月,进行了CT扫描,发现肝门后方有一个17毫米的淋巴结肿大,并进行了手术治疗,包括肝门和肝动脉淋巴结清扫。目前,他仍然健康。

临床讨论与结论

我们的系统回顾表明,RCC的孤立性胃转移很少见。与有多个转移部位的患者相比,孤立性胃转移患者的中位生存期更长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5686/8055614/879d1cbd33e8/gr1.jpg

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