Metastatic renal cell carcinoma presenting as foot metastasis: case report and review of the literature

Malignant tumors frequently metastasize to bone centrally in the skeleton. Metastatic disease distal to the knee is unusual. Metastasis to the foot (acrometastasis) is rare (0.01%) and is usually a late manifestation of disseminated disease. The purpose of this article is to present a rare case of metastatic renal cell carcinoma with foot metastasis as the primary manifestation along with another rare localization of metastatic disease distal to the knee, in the contralateral tibial diaphysis. To highlight the delay in diagnosis of such a rare condition to consider it in the diagnosis of a painful foot, we also present a review of the literature.     

未分类肾细胞癌１例分析并文献复习

目的提高对未分类肾细胞癌(URCC)的认识及临床诊疗水平。方法回顾分析我院收治的1例URCC,结合文献就其诊疗现状及预后进行讨论。结果患者行肾癌根治术,术后愈合良好;术后随访2年,无复发及转移。结论 URCC临床罕见,预后不良,诊断主要依赖其病理学检查,肾癌根治性切除术是其主要治疗方法。     

Metastatic renal cell carcinoma of the nasal septum

Renal cell carcinoma tends to metastasize early to nearly all organs. In the head and neck region, the nasal cavities and paranasal sinuses are targets for its hematogenous spread. This is a case report of a renal cell carcinoma involving the nasal septum that presented as severe epistaxis after a nephrectomy for its primary and after a finger amputation for its metastatic site.     

嫌色细胞型肾细胞癌3例的临床病理特点及文献复习

目的：研究嫌色细胞型肾细胞癌(CRCC)的临床病理特点．方法：采用常规HE染色光镜观察、胶体铁染色、免疫组织化学染色和透射电镜观察．结果：患年龄分别为62、63和67(平均64)岁，均为男性．主诉为腰部酸胀，无明显血尿和腰部包块．所有肿瘤分期均为T0N0M0,组织学上，肿瘤细胞为多变的网状透明胞质的大细胞构成,根据网状化胞质的程度和分布，肿瘤细胞可分为3种类型,细胞的超微结构特征是在网状化的区域存在大量小泡，似乎是CRCC的特征性结构.小泡可能起源于线粒体外膜的外突．胶体铁染色阳性也是CRCC的特征之一．免疫组织化学研究显示肿瘤对(CKpan、CK19、上皮膜抗原和波形蛋白有不同程度的阳性，S-100蛋白阴性.15-26mo的随访表明生存良好。结论：这些发现进一步确证CRCC是肾细胞癌的一种特殊亚型，其典型的形态特征是存在胞质内小泡。     

多房性囊性肾癌合并肾乳头状细胞癌1例报告并文献复习

肾乳头状细胞癌(papillary renal cellcarcinoma,PRCC),起源于肾小管上皮细胞,临床上较少见,约占RCC(renal cell carcinoma,RCC)的7%～15%,囊性RCC是RCC中一种罕见类型,约占RCC的1%～4%。多房性囊性RCC(multilocular cystic renal cell carcinoma,MCRCC)为囊性RCC的一种,约占RCC的0.59%。同时合并PRCC及MCRCC的病例非常罕见,目前尚无文献报道。现对复旦大学附属华东医院泌尿外科收治     

Simultaneous renal cell carcinoma and angiomyolipoma in a kidney--a case report and literature review

Renal cell carcinoma (RCC) is the most common tumor of the kidney. Angiomyolipoma is frequently present in the patient who has the stigma of tuberous sclerosis. We reported a case of a 39-year-old female, without the stigma of tuberous sclerosis, who was admitted on account of a firm, huge, fixed and palpable mass over the left flank region for one week. After radical nephrectomy, the pathological report was renal cell carcinoma, granular cell type, associated with angiomyolipoma. The literature concerning this unusual case is reviewed.     

囊性肾癌的诊断和治疗12例报道并文献复习

目的 旨在提高对囊性肾癌的认识.方法 回顾性分析12例囊性肾癌患者的临床特点、影像学表现、手术方式的选择、病理特点及随访情况. 结果 11例行肾癌根治术,1例行肾肿瘤剜除术.病理分期T1期7例,T2期4例,T3期1例.11例术后随访平均28个月(8～60个月),无瘤存活10例. 结论 囊性肾癌是一种少见的临床病理亚型,CT表现相对有特征性,对可疑囊性肾癌患者,术中须行病理检查,确诊后,肾癌根治术治疗效果满意,预后佳.     

原发性甲状腺鳞状细胞癌1例并文献复习

 观察1例原发性甲状腺鳞癌患者的诊治经过,结合文献分析原发性甲状腺鳞状细胞癌的临床特征和生存相关因素。早期诊断和早期治疗对于原发性甲状腺鳞癌患者的生存质量和生存时间具有决定性的作用。甲状腺良性肿瘤长期刺激也有可能导致细胞鳞状化生和癌变,早期手术并能完整切除肿瘤是最重要的决定预后的因素,放化疗可进一步延长患者的生命。临床工作重点是早期诊断甲状腺鳞癌,甲状腺良性肿瘤的随访和处理应该更积极,治疗上首选手术,可适当辅以放化疗。     

嗜酸细胞乳头状肾细胞癌3例报道并文献复习

目的:探讨嗜酸细胞乳头状肾细胞癌(OPRCC)的临床病理学特点。方法:对3例OPRCC进行光镜观察、免疫组织化学标记及荧光原位杂交检测并复习相关文献。结果:3例OPRCC中,2例男性,1例女性,年龄分别为41、45、65岁。3例均为体检发现肾肿块,例1及例2肿块位于肾下极,例3位于肾中上级,与周围肾组织分界清楚,长径分别为3.0、3.5及4.5 cm,瘤细胞细胞质丰富,嗜酸性,核Fuhrman分级2~3级,瘤细胞排列呈乳头状,乳头内见泡沫细胞聚集。免疫表型3例瘤细胞vimentin、CK7、CD10、AMACR、EMA、CK均阳性,而TFE3、CD15、CD117、RCC、E-cadherin等均阴性。荧光原位杂交检测显示3例瘤细胞均有7、17号染色体扩增。结论:OPRCC是肾细胞癌的罕见亚型,免疫表型及分子遗传学与1型乳头状肾细胞癌相似。应与嗜酸细胞瘤、嫌色性肾细胞癌、Xp11.2易位肾细胞癌等相鉴别。     

Metastatic basal cell carcinoma

Metastatic basal cell carcinomas of the skin are rare tumors. Early excision of the primary lesion remains the best method of treatment, although unresectable tumors can be controlled by radiation therapy. Patients with regional lymph node metastases can be managed by radical lymph node dissection, while those with systemic metastases can be palliated by a combination of chemotherapy, radiation therapy, and surgery.     

Tuberous sclerosis complex associated renal clear cell carcinoma(a case report and literature review)

<正>Objective To explore the diagnosis and treatment features of tuberous sclerosis complex associated renal cell carcinoma. Methods A 22-year-old boy with a childhood history of epilepsy and mental retardation pres-     

肾盂鳞状细胞癌伴同侧输尿管鳞状细胞癌2例报告并文献复习

目的 探讨肾孟鳞状细胞癌伴同侧输尿管鳞癌的临床病理特征.方法 回顾性分析2例肾盂鳞癌伴同侧输尿管鳞癌患者的临床病理资料.病例1男,68岁,血尿1月入院,CT检查示右肾盂及输尿管下段占位,行根治性肾输尿管切除加膀胱袖套状切除术.病例2男,60岁,左腰部及左下腹痛1月外院诊断为左输尿管结石行输尿管切开取石术,术中见输尿管下段肿物,活检示鳞状细胞癌,转我院手术.术中见左肾下极肿物伴结肠侵犯,行根治性肾输尿管切除膀胱袖套状切除左半结肠切除及扩大淋巴结清扫术.2例患者术后均未行放化疗.结果 病理报告病例I肾盂及输尿管均为中分化鳞癌,侵及肾盂a膜下层及输尿管浅肌层.病例2肾孟中分化鳞癌,结肠受侵,输尿管下段低分化鳞癌,伴腹膜后淋巴结转移.分别于术后5个月和6个月死于肿瘤复发转移.结论 肾盂鳞状细胞癌伴同侧输尿管鳞状细胞癌临床罕见,早期诊断困难,术后短期内易复发转移,预后极差.     

拟似黏液性小管状和梭形细胞癌的乳头实性状肾细胞癌2例报道及文献复习

目的:探讨实性乳头状肾细胞癌(sPRCC)临床病理特点及其与黏液性小管状和梭形细胞癌(MTSC)鉴别。方法:对2例sPRCC进行光镜、特殊染色、免疫组织化学染色及荧光素原位杂交(FISH)检测,并复习临床资料及相关文献。结果:2例sPRCC均为男性,年龄分别为50岁和71岁,例2临床表现为腰痛。肿瘤长径分别为2.0 cm、3.5 cm,切面灰白色与周围肾实质界限清晰,例2局部伴出血、坏死。组织学上2例瘤细胞均呈圆形或卵圆形,排列成管状,部分区域瘤细胞相互挤压形成实性片状,例1部分区域瘤细胞排列成梁状,肿瘤边缘见少量乳头状结构,但无脉管轴心,间质内含少量黏液及砂粒体样钙化小体;例2间质内见泡沫细胞聚集,实性片状区域黏液性间质明显。免疫表型:2例均表达AMCAR、CK7、CK19、EMA、vimentin等,Ki-67<5%。FISH结果显示2例均有7号、17号染色体扩增及Y染色体丢失。结论:sPRCC为罕见的乳头状肾细胞癌亚型,形态学及免疫组织化学与MTSC有较多重叠性,常难以区分,FISH检测可有效帮助鉴别。     

脾转移性神经内分泌癌1例及文献复习

目的:探讨脾转移性神经内分泌癌的临床及病理形态学特点、诊断及鉴别诊断。方法:应用石蜡切片光镜观察、免疫组织化学染色等方法,结合临床表现、影像学资料对1例脾转移性神经内分泌癌进行分析,并复习文献。结果:患者男性,30岁,临床症状主要表现为疲乏、发热、左上腹痛、中度脾肿大伴脾破裂,彩色多普勒超声和CT检查发现脾内占位。病理检查见癌组织位于脾脏自发性破裂口的周围实质(局限于红髓)及脾门软组织内,癌细胞排列成实性、梁状、腺样、假菊形团样结构,间质纤维组织分隔瘤细胞团;细胞中等大小,形态相对一致,胞质嗜酸性,核居中,圆形或卵圆形,核仁清楚,病理性核分裂象少见,脾门淋巴结及血管可见癌累犯。免疫组织化学示癌细胞CD56(2+~3+),Syn (1+),CgA、CK (±)。结论:脾转移性神经内分泌癌临床甚罕见,形态与发生于其他器官的神经内分泌癌类似,免疫组织化学有助诊断。     

Metastatic basal cell carcinoma.

A case of basal cell carcinoma which metastasized to an axillary lymph node is presented. There were no histological features that enabled either the presumed primary lesion or the metastasis to be distinguished from the usual non-metastasizing basal cell carcinoma. Evidence is presented that metastasis is considerably less freguent in Queensland that is reported in an overseas series.     

Metastatic ovarian squamous cell carcinoma

Ovarian squamous cell carcinoma is usually associated with germ cell tumours (dermoid cyst) or endometriosis in primary cancer. While tumour metastasis to the ovary is common and often bilateral in over 50 percent of cases, metastatic cervical squamous cell carcinoma to the ovary is infrequent compared to adenocarcinoma from other extraovarian primaries and the cervix. We report two cases of unilateral metastatic ovarian squamous cell carcinoma from the uterine cervix in two women aged 38 years and 48 years, respectively. They presented with abdominopelvic masses, clinically thought to be tuberculosis and primary ovarian tumour, respectively. Both had laparotomy which revealed multinodular ovarian masses with extensive extra-ovarian involvement of the corpus and uterine cervix by tumour and omental seedlings. Tissue microscopy showed total replacement of ovarian stroma by tumour with necrotic foci and containing infiltrating nests and cords of malignant squamous cells with prominent intercellular bridges. No evidence of teratoma or endometriosis was seen in the histology sections. They were both diagnosed with metastatic ovarian squamous cell carcinoma with advanced stage disease primary in the uterine cervix. Ovarian metastatic squamous cell carcinoma from the uterine cervix may occur with advanced stage cervical carcinoma. Unilateral multinodular ovarian mass with extensive extra-ovarian tumour involvement should raise suspicion of metastasis rather than of primary tumour. Early and prompt diagnosis is desirable in the management of these patients.     

阴道平滑肌肉瘤1例报道并文献复习

目的探讨阴道平滑肌肉瘤的临床特点、诊治方法及预后。方法收集并分析大连大学附属中山医院2017年6月30日收治的1例经病理证实为阴道平滑肌肉瘤患者的临床资料,并回顾分析相关文献。结果该患者自二次手术后再次复发,经25次放疗后带瘤生存1年未发现肿瘤进展迹象。结论彻底手术切除肿瘤对于阴道平滑肌肉瘤患者的预后有重要意义,即使术后局部复发,若及时再次手术对患者预后延长生命具有积极影响,且术后及时辅以放疗可能使患者获益。     

肺转移性滤泡树突细胞肉瘤1例报道并文献复习

目的 提高对滤泡树突细胞肉瘤的认识,探讨其系统的治疗方案.方法 报告我科收治的1 例肺转移性滤泡树突肉瘤的病例并复习国内外文献,对该病例的诊断及治疗方法进行分析.结果 本例经2 次局部手术、术后放疗及环磷酰胺、多柔比星、长春新碱、泼尼松(CHOP 方案) 联合化疗后,仍较早出现肺部转移,并进展迅速,行左肺舌段解剖性切除、淋巴结清扫,经病理证实为转移性滤泡树突细胞肉瘤.术后3 个月,左肺上叶再次发现转移性肿物.结论 滤泡树突细胞肉瘤为罕见肿瘤,其恶性程度高,应重视系统治疗.