Department of Pathology, Baylor Scott & White Medical Center - Temple, Temple, TX, USA.
Division of Anatomic Pathology, Texas A&M College of Medicine, Baylor Scott & White Health, Baylor S&W Medical Center West Campus, Temple, TX, USA.
Int J Surg Pathol. 2024 Dec;32(8):1552-1556. doi: 10.1177/10668969241231983. Epub 2024 Feb 26.
Metastasis of clear cell renal cell carcinoma (clear cell RCC) to the gynecologic tract is infrequent, and involvement of the uterus is extremely rare. A review of the literature identified a total of 12 reported examples with metastasis to the uterine serosa (1), endometrium (5), cervix (5) and only one with metastasis to the myometrium. This report represents the first case of tumor-to-tumor metastasis involving a clear cell RCC with metastasis to a uterine leiomyoma. The patient was a 50-year-old woman status post-radical nephrectomy for newly diagnosed unilateral clear cell RCC (stage pT3a) with negative margins, who subsequently underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy for the incidental finding of multiple uterine masses measuring up to 14.5 cm suggestive of fibroid on pelvic ultrasound. The pathologic exam of the specimen was consistent with metastatic clear cell RCC (1.2 cm) to uterine leiomyoma, confirmed with keratin, vimentin, CD10, CA9, and PAX8 immunohistochemistry. The patient's postoperative course was uneventful, and no new lesions were identified at follow-up during the past 6 months.
肾透明细胞癌（clear cell RCC）转移至妇科生殖道并不常见，子宫受累极为罕见。文献复习共发现 12 例明确报道的转移至子宫浆膜（1）、子宫内膜（5）、宫颈（5）的病例，仅有 1 例转移至子宫肌层。本例报告代表首例涉及透明细胞 RCC 的肿瘤对肿瘤转移至子宫平滑肌瘤。患者为 50 岁女性，因新诊断的单侧透明细胞 RCC（分期 pT3a）行根治性肾切除术，切缘阴性，随后因意外发现多个盆腔超声提示达 14.5 cm 的子宫肿块（提示为子宫肌瘤）行全子宫切除术及双侧输卵管卵巢切除术。标本的病理检查与转移性透明细胞 RCC（1.2 cm）至子宫平滑肌瘤一致，免疫组化显示角蛋白、波形蛋白、CD10、CA9 和 PAX8 阳性。患者术后情况平稳，在过去 6 个月的随访中未发现新病灶。
