Baba K, Yamaguchi O, Nomiya M, Hashimoto T, Yoshimura Y, Shiraiwa Y, Sato Y, Iwaya F, Hoshino S
Department of Urology, Fukushima Medical College.
Hinyokika Kiyo. 1995 May;41(5):369-72.
The patient was a 35-year-old female with the chief complaint of macrohematuria. Computerized tomographic (CT) scan, ultrasonography and magnetic resonance imaging (MRI) revealed the presence of a large and inhomogeneous mass in the left kidney, and a tumor thrombus growing in the inferior vena cava. Angiography also showed a hypervascular tumor in the left kidney. The chest X-ray and CT scan demonstrated multiple metastatic lesions in the bilateral lungs. Radical nephrectomy and thrombectomy was performed under the diagnosis of left renal tumor with its invasion of inferior vena cava. Pathological findings revealed that this tumor was nephroblastoma, and its type was clear cell sarcoma of the kidney (CCSK). The patient received chemotherapy according to National Wilms' Tumor Study (NWTS) IV chemotherapeutic drug regimen. In general, CCSK is known to have poor prognosis. However, doxorubicin has been reported to have a relatively good antitumor effect for CCSK. However, in this case, the evaluation after the first course of chemotherapy was progressive disease, because some new lesions appeared, although most old pulmonary metastatic lesions were reduced.
该患者为一名35岁女性，主要症状为肉眼血尿。计算机断层扫描（CT）、超声检查和磁共振成像（MRI）显示左肾有一个大的、不均匀的肿块，下腔静脉内有肿瘤血栓生长。血管造影也显示左肾有一个高血运肿瘤。胸部X线和CT扫描显示双侧肺部有多个转移灶。在诊断为左肾肿瘤侵犯下腔静脉后，进行了根治性肾切除术和血栓切除术。病理结果显示该肿瘤为肾母细胞瘤，其类型为肾透明细胞肉瘤（CCSK）。患者按照国家威尔姆斯肿瘤研究（NWTS）IV化疗药物方案接受化疗。一般来说，已知CCSK预后较差。然而，据报道阿霉素对CCSK有相对较好的抗肿瘤作用。然而，在本病例中，第一个化疗疗程后的评估为疾病进展，因为尽管大多数旧的肺转移灶有所缩小，但出现了一些新病灶。
