Xie Kun, Li Xi-Ya, Liao Bang-Jie, Wu Si-Cheng, Chen Wei-Min
Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang 330036, Jiangxi Province, China.
World J Clin Cases. 2022 Jun 16;10(17):5884-5892. doi: 10.12998/wjcc.v10.i17.5884.
Small cell carcinoma (SCC) is a malignant tumour that is frequently accompanied by extensive metastasis. Primary renal SCC has typical characteristics related to SCC and is extremely rare, with no uniform treatment standard. Clinical treatment is mainly based on the literature. Here we report the diagnosis and treatment of an interesting case of primary renal SCC.
We report a tortuous course of treatment for a 68-year-old man. Four years before diagnosis, the patient developed continuous gross haematuria, during which he underwent several ureteral biopsies, ureteral stricture relief, and urine exfoliated cell examinations; however, SCC was not confirmed. One month before radical resection of the renal pelvic carcinoma, the severe haematuria recurred. Computed tomography revealed transitional cell carcinoma in the right kidney and right upper ureter. A preoperative examination exluded the possibility of a pulmonary origin of the tumour, and primary renal SCC was diagnosed. The postoperative pathology findings were suggestive of SCC. The patient was treated with combined chemotherapy but died of tumour progression at 7 mo postoperative.
Our patient's disease onset in the context of a succession of regular testing and the fact that it occurred so quickly with perirenal encroachment immediately after diagnosis reveals the cruel and unforgiving side of the disease. Furthermore, patients with poor comprehensive treatment results require new treatment regimens.
小细胞癌(SCC)是一种常伴有广泛转移的恶性肿瘤。原发性肾小细胞癌具有与小细胞癌相关的典型特征,极为罕见,且没有统一的治疗标准。临床治疗主要依据文献。在此,我们报告一例原发性肾小细胞癌有趣病例的诊断与治疗情况。
我们报告一名68岁男性曲折的治疗过程。在确诊前四年,患者出现持续性肉眼血尿,在此期间他接受了多次输尿管活检、输尿管狭窄解除术以及尿液脱落细胞检查;然而,未确诊为小细胞癌。在肾盂癌根治性切除术前一个月,严重血尿再次出现。计算机断层扫描显示右肾及右输尿管上段移行细胞癌。术前检查排除了肿瘤肺源性的可能性,诊断为原发性肾小细胞癌。术后病理结果提示为小细胞癌。患者接受了联合化疗,但术后7个月因肿瘤进展死亡。
我们的患者在一系列常规检查的情况下发病,且在诊断后迅速出现肾周侵犯,这揭示了该疾病残酷无情的一面。此外,综合治疗效果不佳的患者需要新的治疗方案。