Department of Radiology, Division of Radiation Oncology, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H8L6, Canada.
Department of Medicine, Division of Rheumatology, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H8L6, Canada.
Curr Oncol. 2021 May 7;28(3):1744-1750. doi: 10.3390/curroncol28030162.
Approximately 20% of renal cell carcinoma (RCC) is diagnosed because of paraneoplastic manifestations. RCC has been associated with a large variety of paraneoplastic syndromes (PNS), but it is rarely associated with PNS vasculitis. We present a case of a previously healthy male who presented with systemic vasculitis; bitemporal headaches, diplopia, polyarthritis, palpable purpura, tongue lesion, peri-orbital edema, scleritis, chondritis and constitutional symptoms. He was subsequently found to have oligometastatic RCC. Both his primary lesion and site of oligometastasis were treated with stereotactic radiotherapy (SBRT) and resulted in the resolution of his vasculitis, as well as sustained oncologic response. This is the first case to demonstrate that effective sustained treatment for PNS vasculitis due to oligometastatic RCC is possible with SBRT.
大约 20%的肾细胞癌 (RCC) 是由于副肿瘤表现而被诊断出来的。RCC 与多种副肿瘤综合征 (PNS) 相关，但很少与 PNS 血管炎相关。我们报告了一例先前健康的男性，他表现为全身血管炎；双侧颞部头痛、复视、多发性关节炎、可触及性紫癜、舌病变、眶周水肿、巩膜炎、软骨炎和全身症状。随后发现他患有寡转移 RCC。他的原发性病变和寡转移部位均采用立体定向放射治疗 (SBRT) 治疗，结果他的血管炎得到缓解，并且肿瘤持续缓解。这是首例证明 SBRT 可有效持续治疗寡转移 RCC 引起的 PNS 血管炎的病例。
