Wu Shuo, Zuo Yuliang, Ye Meihong, Wang Kuan, Wang Xiaolong, Yang Xudong, Wang Chaoming
Department of Urology, Huanghe Sanmenxia Hospital Affiliated to Henan University of Science and Technology, Sanmenxia, Henan 472000, P.R. China.
Department of Pathology, Huanghe Sanmenxia Hospital Affiliated to Henan University of Science and Technology, Sanmenxia, Henan 472000, P.R. China.
Oncol Lett. 2024 Oct 23;29(1):21. doi: 10.3892/ol.2024.14768. eCollection 2025 Jan.
The co-occurrence of clear cell renal cell carcinoma (ccRCC) and bladder urothelial carcinoma (bUC) is rare, and owing to the lack of a unified treatment plan, the prognosis is poor. The present report describes the case of a 65-year-old male patient with a history of smoking and no history of malignant tumors who presented with hematuria at the Huanghe Sanmenxia Hospital Affiliated to Henan University of Science and Technology (Sanmenxia, China) in July 2021. Urinary system computed tomography urography revealed a right renal tumor, and cystoscopy revealed intravesical lesions. The patient underwent transurethral resection of a bladder tumor + laparoscopic partial nephrectomy + laparoscopic radical cystectomy and bilateral ureterostomy. Pathological examination revealed right-sided ccRCC (pT1aN0M0) and high-grade invasive bUC (pT2N0M0). After surgery, the patient underwent bilateral ureteral single J tube replacement in the outpatient clinic every 3 months. In September 2022, the patient presented with a mass on the right side of the neck. Further examination revealed a space-occupying lesion in the lower part of the left kidney and space-occupying lesions in the neck, axilla, mediastinal lymph nodes and liver. A neck lymph node puncture biopsy suggested UC, and the patient was diagnosed with metastatic UC (T4N0M1). The patient received tislelizumab (200 mg once every 3 weeks) + sunitinib (50 mg/day, administered for 4 weeks with a 2-week interval) for a total of 2 months and died of an advanced tumor in January 2023. In addition, the data of 36 patients with ccRCC and bUC from the literature were analyzed for the present report. The results showed that the median age at first onset was 56.5 years (range, 31-82 years) and the male-to-female ratio was 6:1. Smoking and male sex may be risk factors for this disease, which has a median survival time of 47.5 months. The survival analysis results showed that the pathological stage of bladder cancer may be associated with its prognosis. The present study reviews the potential risks, clinicopathological characteristics and treatment methods of co-occurrence of clear ccRCC and bUC. In conclusion, the high-risk factors for the co-occurrence of ccRCC and bUC were smoking and male sex, and the median survival time was 47.5 months. The pathological stage of bladder cancer may be related to the prognosis.
透明细胞肾细胞癌（ccRCC）与膀胱尿路上皮癌（bUC）同时发生的情况较为罕见，由于缺乏统一的治疗方案，预后较差。本报告描述了一名65岁男性患者的病例，该患者有吸烟史，无恶性肿瘤病史，于2021年7月在河南科技大学附属黄河三门峡医院（中国三门峡）因血尿就诊。泌尿系统计算机断层扫描尿路造影显示右肾肿瘤，膀胱镜检查发现膀胱内病变。患者接受了经尿道膀胱肿瘤切除术+腹腔镜部分肾切除术+腹腔镜根治性膀胱切除术及双侧输尿管造口术。病理检查显示右侧ccRCC（pT1aN0M0）和高级别浸润性bUC（pT2N0M0）。术后，患者每3个月在门诊进行双侧输尿管单J管置换。2022年9月，患者右侧颈部出现肿块。进一步检查发现左肾下部有占位性病变，颈部、腋窝、纵隔淋巴结和肝脏也有占位性病变。颈部淋巴结穿刺活检提示为UC，患者被诊断为转移性UC（T4N0M1）。患者接受替雷利珠单抗（200mg，每3周一次）+舒尼替尼（50mg/天，服用4周，间隔2周）治疗共2个月，于2023年1月死于晚期肿瘤。此外，本报告还分析了文献中36例ccRCC和bUC患者的数据。结果显示，首发时的中位年龄为56.5岁（范围31-82岁），男女比例为6:1。吸烟和男性可能是该病的危险因素，中位生存时间为47.5个月。生存分析结果显示，膀胱癌的病理分期可能与其预后相关。本研究回顾了透明ccRCC和bUC同时发生的潜在风险、临床病理特征及治疗方法。总之，ccRCC和bUC同时发生的高危因素为吸烟和男性，中位生存时间为47.5个月。膀胱癌的病理分期可能与预后相关。
