Bianco Prevot Luca, Fozzato Stefania, Cannavò Luca, Accetta Riccardo, Amadei Federico, Basile Michela, Leigheb Massimiliano, Basile Giuseppe
IRCCS Orthopaedic Institute Galeazzi, 20161 Milan, Italy.
Orthopaedic Department, Esine Hospital, 25040 Brescia, Italy.
Healthcare (Basel). 2023 Dec 6;11(24):3108. doi: 10.3390/healthcare11243108.
Cancer of unknown primary (CUP) origin represents a diagnostic and therapeutic challenge. These tumours spread to different parts of the body even if the site of origin has not been identified. When renal metastases are observed without an obvious primary lesion, it is important to exclude the possibility of a primary kidney tumour that may be unknown or too small to be detected. The diagnosis of CUP is established after a careful clinical evaluation and diagnostic tests, including blood chemistry and laboratory tests, instrumental exams (CT, MRI, PET, bone scan), biopsy, and molecular and cytogenetic analysis. Once the diagnosis of CUP with kidney metastases is confirmed, treatment depends on the location of the metastases, the patient's health status, and available treatment options. The latter includes surgery to remove metastases, radiation therapy, or systemic treatment such as chemotherapy or immunotherapy. It is important that patients with CUP are evaluated by a multidisciplinary team of specialists, who can contribute to planning the most appropriate treatment. In this article, we report the clinical case of a patient with a pathological fracture of the proximal humerus which occurred on metastases of probable renal origin in the absence of primary lesions.
原发灶不明的癌症（CUP）是一种诊断和治疗难题。这些肿瘤即使原发部位尚未确定，也会扩散至身体的不同部位。当观察到肾转移而无明显原发灶时，排除可能未知或过小而无法检测到的原发性肾肿瘤的可能性很重要。在经过仔细的临床评估和诊断测试后确立CUP的诊断，这些测试包括血液化学和实验室检查、影像学检查（CT、MRI、PET、骨扫描）、活检以及分子和细胞遗传学分析。一旦确诊为伴有肾转移的CUP，治疗取决于转移灶的位置、患者的健康状况以及可用的治疗选择。后者包括手术切除转移灶、放射治疗或全身治疗，如化疗或免疫治疗。重要的是，CUP患者应由多学科专家团队进行评估，他们有助于规划最合适的治疗方案。在本文中，我们报告了一例肱骨近端病理性骨折患者的临床病例，该骨折发生于可能源自肾脏的转移灶，且无原发灶。
