Alzahrani Abdullah Mousa, Aggamy Mohamed A, Joudeh Amani A, Alabdullatif Hanoof A, Alzahrani Hassan, Gomha Mohamed A
Department of Urology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Am J Case Rep. 2021 May 6;22:e931696. doi: 10.12659/AJCR.931696.
BACKGROUND One-third of renal cell carcinoma cases present with an initial metastasis to various organs, emphasizing the tumor's unpredictable behavior. Prognosis is poor once metastasis is discovered. Multiple-organ involvement with metastatic lesions has a particularly dismal survival rate. Surgical resection alone of metastatic masses can extend patient survival with reasonable quality of life. CASE REPORT Here, we present the case of a healthy 46-year-old woman who initially presented with an incidental localized clear cell renal cell carcinoma. During the follow-up period, she presented with sequential asynchronous metastasis to the pancreas, thyroid, skin, contralateral kidney, and lung. She has no family history of malignancy. Her physical examination and laboratory investigations were normal even upon presentation of most of her metastatic organs. The first metastasis was in her sixth year of follow-up. She underwent consecutive metastasectomy of all the organs described above, excluding the lung. She eventually was started on sunitinib after non-resectable lung nodules were discovered. Her survival is now over 10 years since her first metastasectomy, with good performance status. CONCLUSIONS Metastasis to a single organ has a poor prognosis and dramatically affects survival. Nevertheless, our patient had multiple consecutive examples of metachronous metastasis, yet she has survived for over a decade since the occurrence of metastasis. Our case offers more information to fill the gaps in understanding the favorable role of surgical resection in advanced renal cell carcinoma metastasis.
三分之一的肾细胞癌病例初诊时即已出现远处转移，这凸显了该肿瘤行为的不可预测性。一旦发现转移，预后较差。多器官转移的患者生存率尤其低。单纯手术切除转移灶可延长患者生存期并维持较好的生活质量。病例报告：在此，我们报告一例46岁健康女性患者，最初偶然发现局限性透明细胞肾细胞癌。随访期间，她先后出现胰腺、甲状腺、皮肤、对侧肾脏和肺部的异时转移。她无恶性肿瘤家族史。即使在多数转移器官出现症状时，其体格检查和实验室检查仍正常。首次转移发生在随访的第6年。她接受了上述所有器官（不包括肺部）的连续转移灶切除术。在发现肺部有不可切除的结节后，她最终开始使用舒尼替尼治疗。自首次转移灶切除术后，她已存活超过10年，身体状况良好。结论：单一器官转移预后较差，显著影响生存率。然而，我们的患者出现了多次异时转移，但自转移发生后已存活超过十年。我们的病例为理解手术切除在晚期肾细胞癌转移中的有利作用提供了更多信息。
