Department of Pathology, University Hospital La Princesa, Madrid, Spain.
Department of Urology, University Hospital La Princesa, Madrid, Spain.
Rev Esp Patol. 2022 Sep;55 Suppl 1:S69-S73. doi: 10.1016/j.patol.2019.09.002. Epub 2019 Nov 6.
Regression of primary renal cell carcinoma (RCC) is a rare phenomenon and for several reasons many of the reported cases have been questioned. We present a case that can be considered a true spontaneous and complete regression of a primary RCC. A 79-year-old female underwent nephrectomy because a renal tumor. At the time of surgery image studies showed a small para-aortic lymph node. The tumor measured 3cm and was analyzed completely. Histology showed a fibro-inflammatory lesion with necrosis, foamy macrophages and inflammatory cells. No neoplastic cells were observed and the lesion was interpreted as a localized type of xanthogranulomatous pyelonephritis. One year later a CT control scan, showed that the para-aortic lymph node had increased in size to 4cm. Fine needle aspiration revealed features of clear RCC. Metastatic dissemination was limited so surgical removal of the para-aortic lymph node was performed and the cytologic diagnosis confirmed.
原发性肾细胞癌（RCC）的消退是一种罕见的现象，由于多种原因，许多报道的病例受到质疑。我们报告了一个可被认为是原发性 RCC 真正自发和完全消退的病例。一名 79 岁女性因肾肿瘤接受了肾切除术。手术时的影像学研究显示小的腹主动脉旁淋巴结。肿瘤大小为 3cm，且进行了全面分析。组织学显示具有坏死、泡沫状巨噬细胞和炎症细胞的纤维炎性病变。未观察到肿瘤细胞，病变被解释为局灶性黄色肉芽肿性肾盂肾炎。一年后，CT 对照扫描显示腹主动脉旁淋巴结增大至 4cm。细针抽吸显示透明细胞 RCC 的特征。转移扩散有限，因此进行了腹主动脉旁淋巴结切除术，细胞学诊断得到证实。
