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肾细胞癌肾切除术后12年出现胰腺和十二指肠转移：一例报告

Concomitant pancreatic and duodenal metastases 12 years after nephrectomy for renal cell carcinoma: a case report.

作者信息

Tanaka Hideharu, Komori Shuji, Suetsugu Tomonari, Iwata Yoshinori, Watanabe Taku, Tanaka Chihiro, Nagao Narutoshi, Noguchi Kei, Hisamatsu Kenji, Katayama Masaki, Kawai Masahiro

机构信息

Department of Surgery, Gifu Prefectural General Medical Center, 4-6-1, Noishiki, Gifu, Gifu 500-8717, Japan.

Department of Pathology, Gifu Prefectural General Medical Center, 4-6-1, Noishiki, Gifu, Gifu 500-8717, Japan.

出版信息

J Surg Case Rep. 2024 May 3;2024(5):rjae276. doi: 10.1093/jscr/rjae276. eCollection 2024 May.

DOI:10.1093/jscr/rjae276
PMID:38706478
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11068445/
Abstract

In selected patients with metastatic renal cell carcinoma, metastasectomy can achieve prolonged survival. Herein we report a patient with concomitant pancreatic and duodenal metastases occurring 12 years after total right nephrectomy for a renal cell carcinoma. The metastases were successfully treated by a pancreas-sparing duodenectomy and distal pancreatectomy. A 66-year-old man was referred to our hospital with a chief complaint of right upper abdominal pain. He had undergone laparoscopic total right nephrectomy for renal cell carcinoma 12 years before. Enhanced computed tomography showed hypervascular tumors in the pancreatic body and the descending duodenum near the papilla of Vater. Histopathological examination of endoscopic ultrasonography-guided fine needle aspiration cytology specimens revealed metastatic clear cell renal cancer. The patient underwent pancreas-sparing duodenectomy and distal pancreatectomy. He developed a pancreatic fistula after surgery that improved with conservative treatment, and has been free of evidence of recurrence up to 20 months postoperatively.

摘要

在部分转移性肾细胞癌患者中，转移灶切除术可延长生存期。在此，我们报告一例肾细胞癌患者，在右肾全切术后12年出现胰腺和十二指肠转移。通过保留胰腺的十二指肠切除术和胰腺远端切除术成功治疗了转移灶。一名66岁男性因右上腹疼痛为主诉转诊至我院。他12年前因肾细胞癌接受了腹腔镜下右肾全切术。增强计算机断层扫描显示胰体部和靠近 Vater 乳头的十二指肠降部有高血运肿瘤。内镜超声引导下细针穿刺细胞学标本的组织病理学检查显示为转移性透明细胞肾细胞癌。患者接受了保留胰腺的十二指肠切除术和胰腺远端切除术。术后出现胰瘘，经保守治疗后好转，并在术后20个月一直无复发迹象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/fa062a9cbf74/rjae276f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/3426b16411ac/rjae276f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/9ddfe797d303/rjae276f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/f11845de0096/rjae276f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/bea34be65524/rjae276f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/35954bd8cc9f/rjae276f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/fa062a9cbf74/rjae276f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/3426b16411ac/rjae276f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/9ddfe797d303/rjae276f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/f11845de0096/rjae276f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/bea34be65524/rjae276f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/35954bd8cc9f/rjae276f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a2b/11068445/fa062a9cbf74/rjae276f6.jpg

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本文引用的文献

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A case report of the pancreatic and periampullary metastases of renal cell carcinoma, 17 years after surgery.一例肾细胞癌术后17年出现胰腺及壶腹周围转移的病例报告。
Transl Cancer Res. 2021 Oct;10(10):4560-4564. doi: 10.21037/tcr-21-1137.
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Time-dependent change in relapse sites of renal cell carcinoma after curative surgery.根治性手术后肾癌复发部位的时间依赖性变化。
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Gastrointestinal Involvement of Recurrent Renal Cell Carcinoma: CT Findings and Clinicopathologic Features.
复发性肾细胞癌的胃肠道受累：CT表现及临床病理特征
Korean J Radiol. 2017 May-Jun;18(3):452-460. doi: 10.3348/kjr.2017.18.3.452. Epub 2017 Apr 3.
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