一例同步性病变：乳头状肾细胞癌被误诊为肾上腺肿块。

A synchronous lesion: Papillary renal cell carcinoma mistaken as an adrenal gland mass.

作者信息

Fateri Cameron, Chen Kasha, Sun Shawn, O'Connell Ryan, Houshyar Roozbeh

机构信息

Department of Radiological Sciences, University of California Irvine, 101 The City Dr S, Orange, CA, 92868, USA.

Department of Pathology, University of California Irvine, D440 Medical Sciences I, Irvine, CA, 92697, USA.

出版信息

Radiol Case Rep. 2024 Oct 18;20(1):166-169. doi: 10.1016/j.radcr.2024.09.140. eCollection 2025 Jan.

DOI:10.1016/j.radcr.2024.09.140

PMID:39479477

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11522415/

Abstract

In this case report, we describe a diagnosis of papillary renal cell carcinoma in a 76-year-old male patient who was incidentally found to have a left adrenal mass during routine aneurysm surveillance. Computed tomography demonstrated a left adrenal mass and left renal structure which was concerning for renal cell carcinoma. He underwent left adrenalectomy and initial histopathology demonstrated papillary renal cell carcinoma. He subsequently underwent left radical nephrectomy with lymph node dissection. Histopathological analysis of the removed left renal and nodal specimens revealed papillary renal cell carcinoma with lymph node metastasis. However, re-review of the adrenal pathology slides determined the specimen as represented by primary kidney tumor and not adrenal metastasis. This report reviews the presentation and radiological findings of synchronous papillary renal cell carcinoma and differential diagnosis for indeterminate adrenal mass on computed tomography.

摘要

在本病例报告中，我们描述了一名76岁男性患者被诊断为乳头状肾细胞癌的情况。该患者在常规动脉瘤监测期间偶然发现左肾上腺肿块。计算机断层扫描显示左肾上腺肿块和左肾结构，怀疑为肾细胞癌。他接受了左肾上腺切除术，初步组织病理学检查显示为乳头状肾细胞癌。随后他接受了左根治性肾切除术及淋巴结清扫术。对切除的左肾和淋巴结标本进行组织病理学分析，发现乳头状肾细胞癌伴淋巴结转移。然而，对肾上腺病理切片的再次检查确定该标本为原发性肾肿瘤，而非肾上腺转移瘤。本报告回顾了同步性乳头状肾细胞癌的临床表现、影像学表现以及计算机断层扫描中肾上腺肿块不明确时的鉴别诊断。