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| 肾透明细胞癌胃转移的诊断和治疗(附1例报告) |
| 吴承耀1△,张振声1△,许传亮1,王洋2,曾钦松1,徐伟东1,景泰乐1,沈诞1,沈剑1,王富博1,孙颖浩1* |
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| (1. 第二军医大学长海医院泌尿外科,上海 200433; 2. 第二军医大学长海医院病理科,上海 200433) |
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| 摘要: |
| 回顾总结肾癌胃转移的诊断和治疗经验。方法：回顾性分析我院救治的肾癌胃转移1例，并结合相关文献探讨其临床特点、诊断及治疗方法。结果：该例患者以右腰腹部胀痛1月入院，术前CT、胃镜等影像学检查诊断左肾癌、胃间质瘤，行左肾肿瘤根治性切除术，术后病理及免疫组化确诊为肾透明细胞癌，左肾癌切除术后1月行腹腔镜下胃大部切除术，术后病理提示胃转移性肾透明细胞癌。结论：结合文献报道，肾癌胃转移临床罕见，肾癌及转移灶同期发现者尤为少见，胃转移灶多因上腹部疼痛伴有贫血、消化道出血等症状被发现，内镜表现与原发性胃癌、恶性间质瘤等病变无明显差异性，肾癌合并胃转移预后较差，早期诊断较为困难，影像学及内镜检查有助于定位诊断，确诊依靠病理，治疗以根治性手术为主，免疫治疗可能有效改善预后，延长患者的生存期，但仍需要进一步明确。 |
| 关键词: 肾肿瘤 透明细胞癌 胃肿瘤 肿瘤转移 诊断 治疗 |
| DOI：10.3724/SP.J.1008.2011.0575 |
| 投稿时间：2010-11-04修订日期：2011-01-31 |
| 基金项目: |
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| Diagnosis and treatment of gastric metastasis of clear cell renal cell carcinoma: a case report and review of literatures |
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| Abstract: |
| To summarize the diagonsis and the treatment for gastric metastasis from renal cell carcinoma(RCC). Methods：A patient with gastric metastasis from renal cell carcinoma was retrospetively studied.Literautres about gastric metastasis from RCC were also reviewed.Results： the right lumbar abdominal pain was the first complain of the patient. Renal cell carcinomal and Gastrointestina tromal tumor were clinically diagonosed by imaging examination,radical nephrectomy and laparoscopic gastrectomy were performed successfully consequently and the diagnosis of renal cell carcinoma and gastric metastasis from renal cell carcinoma were pathologically confirmed..Conclusions：With the literature reports, although RCC is known for its ubiquitous pattern of metastasis, gastric metastasis from RCC following radical excision of the primary tumor is extremely rare. Gastric metastatic often performed the symptoms of upper abdominal pain with anemia, gastrointestinal bleeding. Prognosis of gastric metastatic renal cell carcinoma is poor.Imaging and endoscopic examination is necessary and may be helpful for the diagnosis,pathological examination is the only way to confirm the diagnosis. Immunotherapy might effectively improve the prognosis, extend the lifetime of the patients, but still needs to be further clarified. |
| Key words: renal carcinoma, gastric cancer, metastasis, diagnosis, treatment |
