Jacobi G H, Schneider H M, Marberger M
Urologe A. 1978 Mar;17(2):64-72.
In 18 patients, histologic evaluation of a solitary distant metastasis with characteristic hypernephroid pattern subsequently led to the diagnosis of renal cell carcinoma. The metastatic lesion was treated surgically in 15 cases; 14 patients underwent radical surgery and one patient with a solitary kidney underwent partial nephrectomy. Osseous metastases were predominant (12 out of 18). There was an excellent morphologic agreement between metastatic and primary lesions: in no case were metastases less differentiated than the primary tumor. Therefore in all cases of metastases with hypernephroid structures an aggressive search for renal malignancy is required. Five-year survival was 5% and identical to a group of 61 patients with metastases and a symptomatic renal cell carcinoma at diagnosis. The poor prognosis was not influenced by surgical extirpation of the solitary metastasis.
在18例患者中，对具有特征性肾样癌模式的孤立性远处转移灶进行组织学评估，随后诊断为肾细胞癌。15例患者的转移病灶接受了手术治疗；14例患者接受了根治性手术，1例孤立肾患者接受了部分肾切除术。骨转移最为常见（18例中有12例）。转移灶与原发灶在形态学上高度一致：在所有病例中，转移灶的分化程度均不低于原发肿瘤。因此，对于所有具有肾样结构的转移灶病例，都需要积极寻找肾脏恶性肿瘤。五年生存率为5%，与一组61例诊断时伴有转移且有症状性肾细胞癌的患者相同。孤立转移灶的手术切除并未影响预后不良的情况。
