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由转移性生殖细胞肿瘤引起的肾静脉血栓形成,一例非常罕见临床情况的报告。

Renal vein thrombosis due to metastatic germ cell tumor, report of a case with a very rare clinical scenario.

机构信息

Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Cancer Rep (Hoboken). 2023 Dec;6(12):e1910. doi: 10.1002/cnr2.1910. Epub 2023 Oct 8.

Abstract

BACKGROUND

Renal metastasis is a rare manifestation of germ cell tumors. Extension of malignant lesions into the renal vein can complicate the scenario.

CASE

This report presents a 35-year-old man with primary stage IS NSGCT. Fourteen months after radical orchiectomy he presented with metastasis in the lung, kidney, and para-aortic lymph nodes. He received multiple lines of salvage treatments including chemotherapy and surgery. Intraoperative exploration during radical nephrectomy and retroperitoneal lymphadenectomy revealed intra-renal vein involvement with a prominent teratomatous component.

CONCLUSION

Defining the exact extent of malignant lesions, especially endovascular lesions, is very important to clarify how advanced the malignant lesions are. The surgeons must be aware of the risk factors that predict vascular involvement, and therefore, providing intraoperative access to vascular surgery procedures when needed.

摘要

背景

肾脏转移是生殖细胞肿瘤的罕见表现。恶性病变延伸至肾静脉会使情况变得复杂。

病例报告

本病例报告了一名 35 岁的男性,患有原发性 IS NSGCT。根治性睾丸切除术 14 个月后,他出现了肺部、肾脏和腹主动脉淋巴结转移。他接受了多种挽救性治疗,包括化疗和手术。根治性肾切除术和腹膜后淋巴结清扫术的术中探查显示肾静脉内有明显的畸胎瘤成分。

结论

明确恶性病变的准确范围,特别是血管内病变的范围,对于确定恶性病变的严重程度非常重要。外科医生必须了解预测血管受累的危险因素,因此,在需要时提供术中血管外科手术的途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be4b/10728514/5c6df7cfcdc5/CNR2-6-e1910-g002.jpg

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