Wang Wei, Kang Yongcun, Qu Xiaona, Li Yang, Zhou Hongyan
Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Front Oncol. 2024 Dec 4;14:1461791. doi: 10.3389/fonc.2024.1461791. eCollection 2024.
Renal cell carcinoma is the most common type of primary renal cancer, and clear cell carcinoma is the most common subtype, accounting for approximately 70% of all adult renal cell carcinoma cases. At the time of diagnosis, many patients already have metastatic manifestations. Cutaneous metastasis of renal clear cell carcinoma is very rare and usually represents a poor prognosis, mostly affecting the head and neck. In this paper, we report a case of renal clear cell carcinoma with multiple cutaneous metastases, including a chest wall mass for more than 10 years and an abdominal wall mass for 1 year. A 69-year-old man with a history of diabetes mellitus was admitted to the hospital for examination of a right chest and abdominal wall mass and peripheral pain, and ultrasonography suggested a solid space-occupying lesion in the left kidney, which was considered malignant, and a solid mass in the right chest and abdominal wall, which was considered metastatic. A subsequent abdominal CT scan showed malignant tumors in the left kidney and adrenal region, and multiple metastatic tumors in the liver, pancreas, right thoracoabdominal wall, and the abdomen. To clarify the nature of the pathology, an ultrasound-guided puncture of the right abdominal wall mass was performed, and the pathological diagnosis was clear cell carcinoma, with immunohistochemistry suggesting a renal clear cell carcinoma origin. The patient died within 6 months.
肾细胞癌是最常见的原发性肾癌类型，其中透明细胞癌是最常见的亚型，约占所有成人肾细胞癌病例的70%。在诊断时，许多患者已经出现转移表现。肾透明细胞癌的皮肤转移非常罕见，通常提示预后不良，主要累及头颈部。本文报告1例发生多处皮肤转移的肾透明细胞癌病例，包括1个存在超过10年的胸壁肿物和1个存在1年的腹壁肿物。一名有糖尿病病史的69岁男性因右侧胸壁和腹壁肿物及周围疼痛入院检查，超声检查提示左肾有实性占位性病变，考虑为恶性，右侧胸壁和腹壁有实性肿物，考虑为转移性。随后的腹部CT扫描显示左肾和肾上腺区域有恶性肿瘤，肝脏、胰腺、右侧胸腹壁及腹部有多处转移瘤。为明确病理性质，对右侧腹壁肿物进行了超声引导下穿刺，病理诊断为透明细胞癌，免疫组化提示为肾透明细胞癌来源。患者在6个月内死亡。
