METHODS: A 38-year-old male patient was diagnosed pathologically with left RCC after radical nephrectomy in 2012. The patient then suffered multiple lung metastases 2 years later and was treated with oral sorafenib without progression for 6 years. In 2020, an emergency intestinal segmental resection due to intestinal obstruction was required, and postoperative pathology confirmed a jejunal secondary tumor from RCC. The patient had a smooth recovery following surgery. Three months after surgery, the patient was diagnosed with left adrenal metastasis, and subsequent sintilimab therapy has stabilized his condition.
CONCLUSIONS: This report is written to remind urologists and pathologists of the potential for small intestinal secondary tumors when a patient with a history of RCC seeks treatment for digestive symptoms. Enteroscopy and abdominal contrast-enhanced computed tomography are essential means of examination, but severe cases require immediate surgical intervention despite the lack of a preoperative examination to distinguish tumor attributes.
方法:2012年1例38岁男性患者行根治性肾切除术后经病理诊断为左侧肾细胞癌。2年后,患者出现了多个肺转移,口服索拉非尼治疗6年无进展。2020年,由于肠梗阻需要紧急肠段切除术,术后病理证实为肾癌空肠继发性肿瘤。患者在手术后恢复顺利。手术三个月后,患者诊断为左肾上腺转移,随后的sintilimab治疗稳定了他的病情。
结论:本报告旨在提醒泌尿科医师和病理学家,有肾癌病史的患者寻求消化症状治疗时,可能会发生小肠继发性肿瘤。肠镜检查和腹部对比增强计算机断层扫描是必不可少的检查手段,但严重病例需要立即手术干预,尽管缺乏区分肿瘤属性的术前检查.