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首页> 外文期刊>Journal of Medical Case Reports >'Prechronous' metastasis in clear cell renal cell carcinoma: a case report
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'Prechronous' metastasis in clear cell renal cell carcinoma: a case report

机译：透明细胞肾细胞癌的“前期”转移：一例报告

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Introduction Although metastatic carcinoma in the presence of an occult primary tumor is well recognized, underlying reasons for the failure of the primary tumor to manifest are uncertain. Explanations for this phenomenon have ranged from spontaneous regression of the primary tumor to early metastasis of the primary tumor before manifestation of a less aggressive primary tumor. We report a case of 'prechronous' metastasis arising from clear cell renal cell carcinoma, where metastatic disease initially manifested in the absence of a primary renal tumor, followed by aggressive growth of the primary renal lesion. Case presentation A 43-year-old Malay man initially presented to our facility with fever and cough. He subsequently underwent surgical resection of a 9 cm right-sided lung mass found on radiological examination. Histology showed a high-grade clear cell tumor with sarcomatoid differentiation, suggestive of a metastasis from clear cell renal cell carcinoma. However, no concurrent renal lesions were noted on computed tomographic evaluation at that time. Then, four months after lung resection, he presented with a subcutaneous mass in the left loin, as well as right loin discomfort. Computed tomography scanning revealed a 10 cm right renal mass, with renal vein and inferior vena cava invasion, as well as recurrent disease in the right thorax. Histological examination of the excised subcutaneous mass revealed a high-grade carcinoma consistent with clear cell renal cell carcinoma. Conclusions This is the first reported case of prechronous metastasis of renal cell carcinoma, with metastatic disease manifesting prior to the development of the primary lesion. The underlying mechanism is uncertain, but our patient's case provides anecdotal support for the early dissemination model of metastasis.
机译：引言尽管存在隐匿性原发肿瘤的转移性癌已得到公认，但尚无法确定原发性肿瘤未能表现出来的根本原因。这种现象的解释范围从原发性肿瘤的自发消退到原发性肿瘤的早期转移，直至表现出侵略性较低的原发性肿瘤。我们报告了由透明细胞肾细胞癌引起的“先发性”转移病例，其中转移性疾病最初表现为不存在原发性肾脏肿瘤，然后出现原发性肾脏病变的侵袭性增长。病例介绍一名43岁的马来人最初因发烧和咳嗽而出现在我们的诊所。随后，他接受了影像学检查发现的9 cm右侧肺部肿块的手术切除。组织学显示具有肉瘤样分化的高度透明细胞瘤，提示从透明细胞肾细胞癌转移。但是，当时在计算机断层扫描评估中未发现并发的肾脏病变。然后，在肺切除后四个月，他的左腰出现皮下包块，右腰出现不适。计算机体层摄影术扫描显示右肾肿块10厘米，伴有肾静脉和下腔静脉侵犯，以及右胸复发性疾病。切除的皮下肿物的组织学检查显示与透明细胞肾细胞癌一致的高度癌。结论这是首次报道的肾细胞癌的先发转移病例，转移性疾病在原发灶发展之前就已经表现出来。潜在的机制尚不确定，但我们患者的病例为转移的早期传播模型提供了轶事支持。

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