Liu Kuang-Ting, Chang Yueh-Ching, Lin Yu-Chieh, Chang Junn-Liang
Department of Pathology and Laboratory Medicine, Taoyuan Armed Forces General Hospital.
Hsin Sheng Junior College of Medical Care and Management.
Ann Med Surg (Lond). 2024 Jan 4;86(1):456-462. doi: 10.1097/MS9.0000000000001574. eCollection 2024 Jan.
Uterine papillary serous carcinoma (UPSC) is a highly aggressive endometrial carcinoma that often presents as a high-stage disease. UPSC has a high propensity for metastasis and recurrence, even with little or no myometrial invasion. It usually metastasizes to the pelvis, retroperitoneal lymph nodes, upper abdomen, or peritoneum. However, renal metastasis of UPSC is extremely rare.
The authors reported a unique UPSC case in a 75-year-old unmarried woman. Twenty years ago, she had a history of right breast cancer and underwent a modified radical mastectomy. Three years ago, she was diagnosed with endometrial carcinoma, and six courses of chemotherapy and radiotherapy were administered. Computed tomography and retrograde pyelography revealed a right renal pelvic tumor, and a right nephroureterectomy was performed. Renal metastatic UPSC was diagnosed. The patient was administered adjuvant chemotherapy.
Metastatic UPSCs initially presenting at distant sites are uncommon manifestations. This tumor should be differentially diagnosed in patients presenting with metastatic high-grade serous papillary carcinoma of unknown primary origin.
Diagnosing metastatic renal UPSC, based on preoperative and imaging examinations, is often challenging. Thus, a review of the past history, histopathology, and immunohistochemical evaluation plays a crucial and valuable role in the definite and differential diagnosis of this tumor type.
子宫浆液性乳头状癌(UPSC)是一种侵袭性很强的子宫内膜癌,常表现为晚期疾病。UPSC即使在肌层侵犯很少或没有肌层侵犯的情况下,也有很高的转移和复发倾向。它通常转移至盆腔、腹膜后淋巴结、上腹部或腹膜。然而,UPSC的肾转移极其罕见。
作者报告了一例75岁未婚女性的独特UPSC病例。20年前,她有右乳腺癌病史并接受了改良根治性乳房切除术。3年前,她被诊断为子宫内膜癌,并接受了六个疗程的化疗和放疗。计算机断层扫描和逆行肾盂造影显示右肾盂肿瘤,遂行右肾输尿管切除术。诊断为肾转移性UPSC。患者接受了辅助化疗。
远处部位初发的转移性UPSC是不常见的表现。对于表现为原发灶不明的转移性高级别浆液性乳头状癌的患者,应进行鉴别诊断。
基于术前和影像学检查诊断转移性肾UPSC往往具有挑战性。因此,回顾既往病史、组织病理学和免疫组化评估在这种肿瘤类型的明确诊断和鉴别诊断中起着至关重要且有价值的作用。