Wagner J R, Merino M J, Pass H I, Linehan W M, Walther M M
Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
J Urol. 1997 Nov;158(5):1688-90. doi: 10.1016/s0022-5347(01)64096-5.
Spontaneous regression of pulmonary metastases from renal cell carcinoma is a rare but well documented event. We present 2 recent cases that were radiographically consistent with pulmonary metastases from renal cell carcinoma but were pathologically shown to be pulmonary infarcts with no evidence of metastatic cells. Stable pulmonary infarcts can be misconstrued as metastatic disease in patients with renal cell carcinoma while resolving pulmonary infarcts may represent a subpopulation of patients with apparent spontaneous regression. Clinical implications of these findings are discussed.
Clinical and pathological data from 2 patients with large primary renal tumors, venous thrombi and lung masses were reviewed. Data from these cases, as well as pertinent urological and pathological literature, are presented.
Although preoperative assessment was consistent with stage IV renal cell carcinoma, pathological examination of the lung masses in these patients showed no evidence of tumor cells.
Pulmonary infarcts may mimic resolving or stable pulmonary metastasis in patients with renal cell carcinoma. Accurate clinical staging is crucial for the prognosis and treatment of renal cell carcinoma. Mistaking pulmonary infarcts for metastatic lesions can lead to inaccurate prognoses and inappropriate treatment.
肾细胞癌肺转移的自发消退是一种罕见但有充分文献记载的现象。我们报告了2例近期病例，其影像学表现与肾细胞癌肺转移相符，但病理显示为肺梗死，无转移细胞证据。稳定的肺梗死在肾细胞癌患者中可能被误诊为转移性疾病，而正在消退的肺梗死可能代表了明显自发消退患者的一个亚群。讨论了这些发现的临床意义。
回顾了2例患有巨大原发性肾肿瘤、静脉血栓和肺部肿块患者的临床和病理资料。展示了这些病例的数据以及相关的泌尿学和病理学文献。
尽管术前评估与IV期肾细胞癌相符，但这些患者肺部肿块的病理检查未发现肿瘤细胞证据。
肺梗死在肾细胞癌患者中可能类似正在消退或稳定的肺转移。准确的临床分期对肾细胞癌的预后和治疗至关重要。将肺梗死误诊为转移性病变会导致预后不准确和治疗不当。
