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腹腔镜同时处理双原发恶性肿瘤:乙状结肠同步肾细胞癌和结肠癌的病例报告及文献综述

Simultaneous laparoscopic management of dual primary malignancies: case reports and literature review of synchronous renal cell carcinoma and colon carcinoma of sigmoid.

作者信息

Plangsiri Settanan, Ngamdachakij Pat, Jirapornsuwan Manisara, Thepyasuwan Panupol, Sribangpleenoi Chanakarn, Kitgrongpaibul Panjapon, Thongchai Varinthip, Tangmesang Songyos

机构信息

Faculty of Medicine Ramathibodi Hospital, Mahidol University, Rama VI Road, Rajataewe, Bangkok 10400, Thailand.

Faculty of Medicine Ramathibodi Hospital, Chakri Naruebodindra Medical Institute, Mahidol University, Suvarnabhumi Canal Road, Bang Phli, Samut Prakan 10540, Thailand.

出版信息

J Surg Case Rep. 2025 Sep 5;2025(9):rjaf722. doi: 10.1093/jscr/rjaf722. eCollection 2025 Sep.

Abstract

Dual primary malignancy is a rare but possible malignancy presentation. Here, we present two cases of synchronous renal cell cancer and colon cancer with simultaneous laparoscopic management. The first patient, a 65-year-old female, reported painless hematochezia, while the second, a 73-year-old female, complained of painful bloating and constipation, along with a palpable mass in the left lower quadrant of the abdomen. A computed tomography (CT) scan of both patients' abdomens revealed the expected colonic masses. However, surprisingly, the scans also showed hypervascular masses with peripheral enhancement in the kidneys, suggestive of renal cell carcinoma. No evidence of metastasis was found in either patient. A simultaneous laparoscopic sigmoidectomy combined with radical nephrectomy was successfully performed for both patients. Postoperative CT scans and sigmoidoscopy confirmed complete tumor resection with no evidence of local recurrence. The present case report may serve as a valuable reference for managing similar clinical scenarios in the future.

摘要

双原发性恶性肿瘤是一种罕见但可能出现的恶性肿瘤表现形式。在此,我们报告两例同时患有肾细胞癌和结肠癌并采用同期腹腔镜手术治疗的病例。首例患者为一名65岁女性,主诉无痛性便血,而第二例患者为一名73岁女性,主诉有疼痛性腹胀和便秘,同时在左下腹部可触及肿块。对两名患者的腹部进行计算机断层扫描(CT)均显示出预期的结肠肿块。然而,令人惊讶的是,扫描还显示肾脏有血管丰富的肿块且周边强化,提示为肾细胞癌。两名患者均未发现转移迹象。对两名患者均成功实施了同期腹腔镜乙状结肠切除术联合根治性肾切除术。术后CT扫描和乙状结肠镜检查证实肿瘤已完全切除,无局部复发迹象。本病例报告可为未来处理类似临床情况提供有价值的参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f38/12411848/11cd8b39a9c0/rjaf722f1.jpg

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