Elabbady Ahmed, Boudreau Ryan, Mehrnoush Vahid, Salem Mona, Fahmy Ahmed, Elabbady Rawan, Kotb Ahmed
Alexandria University, Alexandria, Egypt.
Northern Ontario School of Medicine University, Ontario, Canada.
Arch Clin Cases. 2023 Jun 12;10(2):93-96. doi: 10.22551/2023.39.1002.10249. eCollection 2023.
Renal cell carcinoma (RCC) frequently spreads to distant organs like the lung, lymph nodes, bone, and liver. However, there have been some reports of RCC bladder metastasis. We present a case of a 61-year-old man presented with total painless gross hematuria. The patient had a history of right radical nephrectomy for papillary (type 2) RCC, high-grade, pT3a with negative surgical margins. There was no evidence of metastases on 6-month surveillance CT. After one-year post-operation, at this current admission, the cystoscopy discovered a solid bladder mass away from the trigone in the right lateral bladder wall. The resected bladder mass was metastatic papillary RCC with PAX-8 positive but GATA-3 negative on immunostaining. A positron emission tomography scan confirmed multiple lung, liver, and osseous metastases. This case report can highlight the importance of having bladder metastasis in RCC mind, although rare, and may necessitate the surveillance measures like urine analysis at more frequent interval and CT Urography instead of regular CT to detect the RCC metastatic bladder cancer at early stage.
肾细胞癌（RCC）常转移至远处器官，如肺、淋巴结、骨和肝脏。然而，已有一些关于RCC膀胱转移的报道。我们报告一例61岁男性患者，表现为全程无痛肉眼血尿。该患者有因乳头状（2型）RCC行右侧根治性肾切除术的病史，肿瘤为高级别，pT3a，手术切缘阴性。术后6个月的监测CT未发现转移证据。术后一年，在本次入院时，膀胱镜检查发现右侧膀胱壁三角区外有一实性膀胱肿物。切除的膀胱肿物为转移性乳头状RCC，免疫染色显示PAX - 8阳性但GATA - 3阴性。正电子发射断层扫描证实有多发肺、肝和骨转移。本病例报告可强调，尽管RCC膀胱转移罕见，但仍需考虑到其可能性，可能需要采取更频繁的尿液分析和CT尿路造影等监测措施，而非常规CT，以便早期发现RCC转移性膀胱癌。
