Bai Gao-Chen, Mi Yue, Song Yi, Hao Jin-Rui, He Zhi-Song, Jin Jie
Department of Urology, Peking University First Hospital, Beijing 100034, China.
World J Clin Cases. 2021 Jul 6;9(19):5339-5344. doi: 10.12998/wjcc.v9.i19.5339.
Secondary jejunal tumor from renal cell carcinoma (RCC) is extremely rare in clinical practice and is easily missed and misdiagnosed because of the low incidence and atypical symptoms.
A 38-year-old male patient was diagnosed pathologically with left RCC after radical nephrectomy in 2012. The patient then suffered multiple lung metastases 2 years later and was treated with oral sorafenib without progression for 6 years. In 2020, an emergency intestinal segmental resection due to intestinal obstruction was required, and postoperative pathology confirmed a jejunal secondary tumor from RCC. The patient had a smooth recovery following surgery. Three months after surgery, the patient was diagnosed with left adrenal metastasis, and subsequent sintilimab therapy has stabilized his condition.
This report is written to remind urologists and pathologists of the potential for small intestinal secondary tumors when a patient with a history of RCC seeks treatment for digestive symptoms. Enteroscopy and abdominal contrast-enhanced computed tomography are essential means of examination, but severe cases require immediate surgical intervention despite the lack of a preoperative examination to distinguish tumor attributes.
肾细胞癌(RCC)继发空肠肿瘤在临床实践中极为罕见,由于发病率低且症状不典型,很容易被漏诊和误诊。
一名38岁男性患者于2012年接受根治性肾切除术后经病理诊断为左肾细胞癌。该患者2年后出现多处肺转移,接受口服索拉非尼治疗,6年病情无进展。2020年,因肠梗阻需行急诊肠段切除术,术后病理证实为空肠继发性肾细胞癌肿瘤。患者术后恢复顺利。术后3个月,患者被诊断为左肾上腺转移,随后接受信迪利单抗治疗,病情稳定。
本报告旨在提醒泌尿外科医生和病理科医生,有肾细胞癌病史的患者出现消化症状寻求治疗时,存在小肠继发性肿瘤的可能性。肠镜检查和腹部增强计算机断层扫描是必不可少的检查手段,但严重病例即使缺乏术前检查以区分肿瘤属性,也需要立即进行手术干预。