Ohgou T, Okahara M, Kishimoto T
Okayama Rosai Hospital, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Apr;36(4):369-73.
A 64-year-old man was admitted to our hospital because of abnormal shadows on chest X-ray films. Malignant mesothelioma was suspected. However a CT scan revealed a large mass in the right kidney and many nodules in the liver and pleura. This suggested that primary renal cell carcinoma had metastasized to the liver and pleura. The patient was treated with transarterial embolization (TAE), alpha and gamma interferon, and UFT, but died of respiratory failure caused by massive bleeding from the pleural metastases. At autopsy, renal cell carcinoma, clear cell subtype, was noted. The many pleural lesions were of the same histologic type, which suggested that they were metastases from the kidney. Renal cell carcinoma frequently metastasizes to the lungs or bones via the arteries. However, many pleural metastases without lung metastasis is rare. We report a case of renal cell carcinoma with many pleural metastases via Batson's venous plexus.
一名64岁男性因胸部X线片出现异常阴影入住我院。怀疑为恶性间皮瘤。然而，CT扫描显示右肾有一个大肿块，肝脏和胸膜有许多结节。这提示原发性肾细胞癌已转移至肝脏和胸膜。该患者接受了经动脉栓塞术（TAE）、α和γ干扰素以及优福定治疗，但因胸膜转移灶大量出血导致呼吸衰竭死亡。尸检时，发现为透明细胞亚型肾细胞癌。许多胸膜病变具有相同的组织学类型，提示它们是来自肾脏的转移灶。肾细胞癌常通过动脉转移至肺或骨。然而，许多胸膜转移而无肺转移的情况较为罕见。我们报告一例通过巴特森静脉丛发生多处胸膜转移的肾细胞癌病例。
