Late Pulmonary Metastasis of Renal Cell Carcinoma-13 Years after Radical Nephrectomy: A Case Report

病歷報告：腎細胞癌的晚發型肺轉移－全腎切除13年後復發

簡志翔(Chih-Hsiang Chien) ； 陳育民(Yuh-Min Chen)

《胸腔醫學》 28卷3期 (2013/06) Pp. 160-164

摘要

在老年病患中發現的肺部腫瘤若是大於三公分，該腫瘤為惡性的可能性大為增加，我們報告一個腎細胞癌的病患，十三年前接受右全腎切除後，才在肺部發現轉移的病例。這位病患的症狀主要是因為咳血數天，於2012/2胸部X光片檢查發現肺部腫瘤。肺部電腦斷層發現右下肺有3.8 x 3 cm的腫塊，同時兩側下肺葉有數個大小不一的結節。最初的影像診斷是肺癌合併肺部轉移。我們安排電腦斷層引導下右下肺腫瘤切片，病理報告是腎細胞癌肺部轉移。腹部電腦斷層顯示左側腎臟正常，右側也沒有腎細胞癌的局部復發。我們報告這個十三年後的腎細胞癌肺部轉移復發，同時也回顧一些過去的文獻報告。

關鍵字

腎細胞癌 ； 晚期肺部復發轉移

並列摘要

Pulmonary nodules larger than 3 cm in the elderly raise the possibility of malignancy. We present a case of pulmonary metastases that occurred 13 years after radical right nephrectomy for renal cell carcinoma. The patient suffered from cough with hemosputum for days. He visited our outpatient department where pulmonary nodules were detected by chest X-ray examination in February 2012. Computed tomography (CT) of the chest revealed a 3.8 x 3.0 cm soft tissue mass at the right lower lobe (RLL) of the lung, and variably-sized nodules at the bilateral lung fields. Lung cancer, RLL, with lung-to-lung metastasis was suspected. CT-guided biopsy was performed for the RLL mass and histopathology disclosed metastatic renal cell carcinoma. Abdominal CT disclosed a normal appearance of the left kidney and no local recurrence of renal cell carcinoma. We present this case and review the literature of late pulmonary recurrence from renal cell carcinoma.

並列關鍵字

renal cell carcinoma ； late pulmonary recurrence