摘要
肾透明细胞癌(ccRCC)是肾细胞癌(RCC)最常见的病理类型,占成人恶性肿瘤的3%~5%。RCC以血运转移为主,常见于肺、肝、骨、肾上腺及脑等器官或组织,转移至胆囊者极为罕见。本文回顾性分析暨南大学附属广州红十字会医院肝胆外科于2021年1月收治的1例左侧ccRCC根治术后8年发现胆囊转移患者的病例资料,入院后发现胆囊占位性病变、右肺结节(结节此前经外院活检未见癌细胞),行腹腔镜下胆囊癌根治术,术后病理确诊为ccRCC胆囊转移。然而随访2个月后发现左肺新发结节,病理证实肺转移性ccRCC,予舒尼替尼靶向治疗。随访15个月,除肺转移灶进展扩散外,未见原发及其他部位肿瘤复发。ccRCC胆囊转移术前根据症状、体征及影像学很难确诊,确诊该病需要依靠病理学检查。为此,本文主要对其影像学、病理学特征、诊治、预后方面进行文献复习,以期提高对此病的认识。
Clear cell renal cell carcinoma(ccRCC) is the most common pathological type of renal cell carcinoma(RCC),accounting for about 3%-5% of adult malignant tumors. RCC is mainly with vascular metastasis, which is common in organs or tissues such as lung, liver, bone, adrenal gland, and brain, but it is very rare that RCC metastasis to gallbladder. This report retrospectively analyzed the case data of a patient with gallbladder metastasis found eight years after radical resection of left ccRCC in the Department of Hepatobiliary Surgery of Guangzhou Red Cross Hospital Jinan University in January 2021. The patient was found to have gallbladder space occupying lesions and right lung nodules(no cancer cells were found in the nodule by out-of-hospital biopsy before) after admission. The lesion was pathologically confirmed as ccRCC gallbladder metastasis during subsequent laparoscopic radical gallbladder cancer surgery. However, after two months’ follow-up, a new nodule was found in the left lung, and was pathologically confirmed to be metastatic ccRCC, which was intervened by delivering Sunitinib. After 15 months’ follow-up, there was no recurrence of primary or other tumors, except for the progression of lung metastases. Preoperative diagnosis of ccRCC gallbladder metastasis based on clinical symptoms,signs and imaging data is challenging, which should be further proved by pathological examination. Therefore, the current report aimed to help better understanding the disease via reviewing the corresponding literature including imaging,pathological features, diagnosis, treatment, and prognosis.
作者
朱山飞
苑伟
杜永良
吴帆
颜勇
王百林
ZHU Shanfei;YUAN Wei;DU Yongliang;WU Fan;YAN Yong;WANG Bailin(Department of Hepatobiliary Surgery,Guangzhou Red Cross Hospital of Jinan University,Guangdong Province,Guangzhou510220,China)
出处
《中国医药导报》
CAS
2022年第33期176-179,192,共5页
China Medical Herald
基金
国家自然科学基金面上项目(81974442)
广东省自然科学基金面上项目(2021A1515011261)
广东省广州市中医药和中西医结合科技项目(20202A011010)。
关键词
胆囊肿瘤
肿瘤转移
肾透明细胞癌
鉴别诊断
胆囊切除术
Gallbladder neoplasms
Neoplasm metastasis
Clear cell renal cell carcinoma
Diagnosis and differential diagnosis
Cholecystectomy
