Sun Juan, Zhang Zimu, Xiao Yu, Li Hanzhong, Ji Zhigang, Lian Penghu, Zhang Xuebin
Division of General Surgery, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Front Surg. 2022 Mar 3;9:762540. doi: 10.3389/fsurg.2022.762540. eCollection 2022.
Skeletal muscle metastasis (SMM) from renal cell carcinoma (RCC) has been rarely reported. This case series was performed to increase the clinicians' understanding of its clinical features and treatments.
We evaluated the clinical presentations, diagnoses, and treatments of 2 patients with SMM from RCC in our hospital and 39 cases reported in the literature.
Among the 41 patients, 4 (9.76%) were women and 37 (90.24%) were all men. The average age was 60.5 ± 12.6 years old (range from 7 to 81). The size of tumors varied from 1 to 28 cm, and the metastatic sites of 6 (14.63%) cases were in the heads, 20 (48.78%) in the limbs, 9 (21.95%) in the trunks, 3 (7.32%) in the buttock, and the other 3 (7.32%) were multiple sites. The mean of intervals between the RCC and the discovery of the first SMM was 73.61 months. More than half of the patients (25, 60.98%) were diagnosed by MRI and 25 (60.98%) patients performed a biopsy of the mass to establish the diagnosis. Finally, 30 (73.17%) cases performed mass excision. Then the adjuvant therapy was performed in 18 patients including immunotherapy, radiotherapy, chemotherapy, and targeted therapy. The median follow-up after SMM was 9 months (P25, P75: 5, 23), in which the longest survival time of patients with SMM of RCC was 8 years while the shortest was only 3 months.
The characteristic clinical feature of SMM from RCC is asymptomatic masses or swelling with a long history which can be preoperative suspiciously diagnosed by MRI. The rapid biopsy of suspected lesions, determination of other metastasis sites, resection of metastasis, and systematic treatment are the recommended treatments of it.
肾细胞癌(RCC)发生骨骼肌转移(SMM)的报道较少。本病例系列旨在提高临床医生对其临床特征和治疗方法的认识。
我们评估了我院2例RCC发生SMM患者的临床表现、诊断和治疗情况,并回顾了文献报道的39例病例。
41例患者中,女性4例(9.76%),男性37例(90.24%)。平均年龄为60.5±12.6岁(7至81岁)。肿瘤大小从1至28 cm不等,6例(14.63%)转移部位在头部,20例(48.78%)在四肢,9例(21.95%)在躯干,3例(7.32%)在臀部,另外3例(7.32%)为多部位转移。RCC与首次发现SMM之间的平均间隔时间为73.61个月。超过半数患者(25例,60.98%)通过MRI确诊,25例(60.98%)患者对肿块进行活检以明确诊断。最终,30例(73.17%)患者进行了肿块切除。随后,18例患者接受了辅助治疗,包括免疫治疗、放疗、化疗和靶向治疗。SMM后的中位随访时间为9个月(P25,P75:5,23),其中RCC发生SMM患者的最长生存时间为8年,最短仅3个月。
RCC发生SMM的特征性临床特点是存在无症状肿块或肿胀且病史较长,MRI可在术前作出可疑诊断。对可疑病变进行快速活检、确定其他转移部位、切除转移灶并进行系统治疗是推荐的治疗方法。