结节病与许多实体和血液系统恶性肿瘤之间存在着公认的联系,但是在肾细胞癌患者中这是较少描述的现象。此外,大多数描述的病例在肿瘤附近表现出局部类肉瘤样反应,而远处疾病的报道相对较少。鉴于病例数量相对较少,在肾细胞癌的背景下,结节病的临床行为仍存在很大的不确定性。我们报告了一例手术切除的肾细胞癌患者,几年后,发展的双侧肺结节,胸内淋巴结病以及脾,肝和骨病变。经过广泛的调查,最终实现了电视胸腔镜手术切除,他被发现患有结节病。在被诊断为心脏结节病之前,他多年来一直无症状,被发现是不活跃的,不需要任何治疗。迄今为止,他的结节病和潜在的肾细胞癌都已缓解。此病例突出了结节病在这些患者中的可变行为,并强调了在可疑转移性疾病的情况下获得准确组织诊断的重要性。此外,它强调了密切监测和长期随访的重要性,因为这些患者可能会出现严重的器官受累,甚至在确诊多年后.有趣的是,患者的肾细胞癌仍处于缓解状态,提出了以下问题:结节病的发展是否预示着潜在实体恶性肿瘤患者的预后更好。
There exists a well-established association between sarcoidosis and many solid and hematologic malignancies however it is a less frequently described phenomenon in patients with renal cell carcinoma. Moreover the majority of described cases presented with local sarcoid-like reactions in close proximity to the tumor with comparatively few reports of more distant disease. Given the relatively low number of cases there remains a great deal of uncertainty surrounding the clinical behaviour of sarcoidosis in the setting of renal cell carcinoma. We report the case of a patient with surgically resected renal cell carcinoma who, several years later, developed bilateral pulmonary nodules, intra-thoracic lymphadenopathy as well as splenic, hepatic and osseous lesions. After extensive investigation, culminating in video-assisted thoracoscopic surgical resection, he was found to have sarcoidosis. He remained asymptomatic for many years before being diagnosed with cardiac sarcoidosis, which was found to be inactive and did not require any treatment. Both his sarcoidosis and underlying renal cell carcinoma have remained in remission to date. This case highlights the variable behaviour of sarcoidosis in these patients and underscores the importance of obtaining an accurate tissue diagnosis in the setting of suspected metastatic disease. Additionally, it underscores the importance of close monitoring and long-term follow up as these patients may develop significant organ involvement, even many years after diagnosis. Interestingly the patient\'s renal cell carcinoma remained in remission, raising questions about whether the development of sarcoidosis portends a better prognosis in patients with an underlying solid malignancy.