Zeng Qinsong, Luo Shuhang, Chen Linze, Chen Lingwu, Chen Junxing
Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China.
Department of Urology, Da Lang Hospital of Dongguan, Dongguan, Guangdong 523777, P.R. China.
Oncol Lett. 2023 May 5;25(6):270. doi: 10.3892/ol.2023.13856. eCollection 2023 Jun.
Renal cell carcinoma (RCC) is a common urinary tumor that may be pathologically divided into different subtypes: clear cell RCC, papillary RCC (PRCC) and chromophobe RCC. The most common organs of RCC metastasis are the lung, liver and bones, while bladder metastasis is rare. The treatment for PRCC metastasis is also a problem due to limited clinical data. Therefore, every single case of PRCC metastasis may significantly contribute to establishing a standard treatment protocol. The present study reported on a patient who suffered from repetitive bladder PRCC metastasis with 1.5 years of follow-up. A 54-year-old male patient was diagnosed with left renal pelvic carcinoma in March 2020 and underwent a laparoscopic radical nephroureterectomy of the left kidney. The postoperative histological examination revealed that the tumor was consistent with a type 2 PRCC. Bladder metastasis was discovered three months after the surgery and transurethral resection of the bladder tumor (TURBT) was performed to eliminate the tumor in the bladder. Only three months after the initial TURBT, bladder metastasis was detected again, combined with lung metastasis. The patient refused to undergo radical cystectomy. Therefore, a second TURBT was arranged and targeted drugs were administered. However, both bladder and lung metastases were insensitive to the treatment strategy applied, although immunotherapy was subsequently added. The patient died in October 2021 due to respiratory failure and cachexia. The report aims to provide the whole treatment progress and lessons learned from this case, which is relatively rare.
肾细胞癌（RCC）是一种常见的泌尿系统肿瘤，在病理上可分为不同亚型：透明细胞肾细胞癌、乳头状肾细胞癌（PRCC）和嫌色细胞肾细胞癌。肾细胞癌转移最常见的器官是肺、肝和骨，而膀胱转移则很少见。由于临床数据有限，PRCC转移的治疗也是一个问题。因此，每一例PRCC转移病例都可能对建立标准治疗方案有显著贡献。本研究报告了一例患有复发性膀胱PRCC转移且随访1.5年的患者。一名54岁男性患者于2020年3月被诊断为左肾盂癌，并接受了左肾腹腔镜根治性肾输尿管切除术。术后组织学检查显示肿瘤符合2型PRCC。术后三个月发现膀胱转移，遂行经尿道膀胱肿瘤切除术（TURBT）以清除膀胱内的肿瘤。仅在初次TURBT术后三个月，再次检测到膀胱转移，并伴有肺转移。患者拒绝接受根治性膀胱切除术。因此，安排了第二次TURBT并给予靶向药物治疗。然而，尽管随后添加了免疫疗法，但膀胱和肺转移对所应用的治疗策略均不敏感。该患者于2021年10月因呼吸衰竭和恶病质死亡。本报告旨在提供该相对罕见病例的整个治疗过程及经验教训。
