Saadaat Ramin, Adelyar Mohammad Asef, Abdul-Ghafar Jamshid, Rahmani Mohibullah, Esmat Esmatullah, Haidary Ahmed Maseh, Malakzai Haider Ali
Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan.
Department of Internal Medicine, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan.
Case Rep Pathol. 2025 Sep 16;2025:5320139. doi: 10.1155/crip/5320139. eCollection 2025.
Metastasis is a critical factor in colorectal cancer (CRC) outcomes, with 22% of patients presenting with metastasis at diagnosis and an eventual 70% experiencing it. This report highlights a rare case of ascending colon adenocarcinoma with metastasis to the kidney, underscoring the diverse and complex nature of CRC progression. A 60-year-old man presented with abdominal discomfort, constipation, and rectal bleeding after colonoscopy revealed a colon mass, leading to a diagnosis of adenocarcinoma after colonoscopic biopsy. Initially without distant metastasis, he underwent four cycles of chemotherapy, but follow-up imaging 6 months later showed liver and renal metastases, prompting a colectomy and nephrectomy. Pathological examination confirmed moderately differentiated adenocarcinoma in both the colon and kidney, with staging indicating advanced disease, and the patient succumbed to his illness shortly after surgery. Metastatic carcinomas to the kidney are uncommon, with CRC metastasis being particularly rare, as evidenced by a limited number of cases in the literature. Typically originating from primary tumors in the lung, liver, and gastrointestinal tract, renal metastases often present as well-defined lesions, complicating the differentiation from primary renal cancers. Our case highlights a solitary, well-circumscribed renal metastasis from CRC, emphasizing the diagnostic challenges and the need for careful evaluation in patients with known malignancies. Metastatic carcinoma of the colorectal tract is very rarely reported to the kidney, it does so at a higher stage of the disease with systemic disease and has a poor outcome for the patient.
转移是结直肠癌（CRC）预后的关键因素，22%的患者在诊断时即出现转移，最终有70%的患者会发生转移。本报告重点介绍了一例罕见的升结肠癌转移至肾脏的病例，强调了结直肠癌进展的多样性和复杂性。一名60岁男性因腹部不适、便秘和直肠出血就诊，结肠镜检查发现结肠肿物，经结肠镜活检后诊断为腺癌。最初无远处转移，他接受了四个周期的化疗，但6个月后的随访影像学检查显示肝和肾转移，遂行结肠切除术和肾切除术。病理检查证实结肠和肾脏均为中分化腺癌，分期为晚期疾病，患者术后不久病逝。肾转移癌并不常见，结直肠癌转移尤为罕见，文献中报道的病例数量有限即证明了这一点。肾转移通常起源于肺、肝和胃肠道的原发性肿瘤，常表现为边界清晰的病变，这使得与原发性肾癌的鉴别变得复杂。我们的病例突出了一例来自结直肠癌的孤立性、边界清晰的肾转移，强调了诊断挑战以及对已知恶性肿瘤患者进行仔细评估的必要性。结直肠转移性癌很少有转移至肾脏的报道，发生时疾病处于较高分期且伴有全身病变，对患者预后不利。
