Balki Indranil, Wang David
Department of Medical Imaging, Western University, Schulich School of Medicine and Dentistry.
Radiol Case Rep. 2024 May 11;19(8):3126-3129. doi: 10.1016/j.radcr.2024.04.055. eCollection 2024 Aug.
Esophageal cancer, consisting primarily of squamous cell carcinoma and adenocarcinoma pathology, is a leading cause of morbidity and mortality worldwide with rates of metastasis at time of diagnosis up to 50%. Renal metastasis is rare, with most pathological diagnosis yielding squamous cell carcinoma. We present the unique case of a 78-year-old man with biopsy proven adenocarcinoma metastasis to the kidney on routine surveillance following initial esophagectomy, chemoradiation and adjuvant immunotherapy. Imaging features of the solitary renal metastasis highly mimicked a primary renal cell carcinoma. Additional unique features included renal pelvis invasion and disease recurrence despite adjuvant immunotherapy. This case underscores the role of routine surveillance in this patient population, varied radiologic appearance, and importance for pathologic diagnosis.
食管癌主要由鳞状细胞癌和腺癌病理类型组成,是全球发病和死亡的主要原因,诊断时转移率高达50%。肾转移罕见,大多数病理诊断为鳞状细胞癌。我们报告了一例独特病例,一名78岁男性,在初次食管切除、放化疗及辅助免疫治疗后的常规监测中,活检证实为腺癌转移至肾脏。孤立性肾转移的影像学特征高度类似于原发性肾细胞癌。其他独特特征包括肾盂侵犯以及尽管进行了辅助免疫治疗仍出现疾病复发。该病例强调了对该患者群体进行常规监测的作用、多样的放射学表现以及病理诊断的重要性。