肾透明细胞癌发生膀胱转移1例报告并文献复习

摘要

本文报道1例肾透明细胞癌发生膀胱转移的临床病理资料。患者女，71岁，于2011年7月29日因“右肾癌合并肺转移瘤”就诊，2011年8月3日行开放经腹腔右肾切除术，术后辅助靶向治疗。2016年4月28日发现左侧孤立肾肾癌，合并膀胱转移，肺、骨转移。2016年5月10日行经尿道膀胱肿瘤电切术。术后病理符合肾透明细胞癌转移至膀胱。2016年5月17日行腹腔镜下左侧孤立肾肾部分切除术。术后病理提示左肾高级别透明细胞癌，伴肾门淋巴结转移。术后第2日急性肾小管坏死，予血液透析治疗。术后随访2个月。血肌酐289μmol／L。双肾区及膀胱未见肿瘤复发。%[Summary] This study reported the clinical and pathological data of one case of renal clear cell carcinoma with bladder metastasis .The patient was a 71-year-old woman who suffered from right renal cell carcinoma associated with pulmonary metastasis . She underwent right nephrectomy on August 3, 2011.Targeted therapy was used as a postoperative adjuvant treatment .On April 28, 2016, it was found that the left solitary kidney suffered from renal cell carcinoma , and there were also bladder metastasis , lung and bone metastasis.Transurethral resection of bladder tumor was performed on May 10, 2016.The pathological result conformed to metastasis of clear cell renal cell carcinoma to the bladder .Laparoscopic partial nephrectomy of the left kidney was conducted on May 17, 2016.Postoperative pathological examination showed that the left kidney tumor was a high grade clear cell carcinoma , with metastasis of renal hilar lymph nodes .Acute tubular necrosis occurred 2 days after operation .Follow-up for 2 months showed serum creatinine was 289 μmol/L.There was no recurrence of tumor in kidney region and bladder .