Synchronous Renal Collecting Duct Carcinoma and Transitional Cell Carcinoma: A Case Report

集尿管腎細胞癌同時合併腎盂移行性細胞癌：病例報告

王耀明(Yao-Ming Wang) ； 吳清俊(Ching-Jiunn Wu) ； 孫光煥(Guang-Huan Sun) ； 許來發(Lai-Fa Sheu) ； 周定遠(Ting-Ywan Chou) ； 陳震宇(Cheng-Yu Chen)

《中華放射線醫學雜誌》 32卷2期 (2007/06) Pp. 87-92

摘要

集尿管腎細胞癌同時合併腎盂移行性細胞癌是一極罕見的腎臟多重型惡性腫瘤且預後很差。我們報告一位57歲女性，患有一從右腎集尿系統與實質組織長出之兩種不同癌細胞腫瘤，併有發燒、腰痛症狀。此腫瘤非侷限於腎臟集尿系統，也未穿出腎包膜外，此罕見的部位是很難與一般腎臟細胞癌及移行性細胞癌鑑別。在放射線影像學上，若疑似集尿管癌建議先經皮穿刺切片由病理確診後，再進行下一步之治療計畫，藉以延長病患存活期。在此我們提出這罕見案例的影像與病理組織發現以及探討相關的文獻資料。

並列摘要

Renal carcinoma of the collecting ducts of Bellini account for less than 1% of all renal tumors. Here, we report a 57-year-old female with synchronous transitional cell carcinoma in the renal pelvis and collecting duct carcinoma in the renal parenchyma. In this challenging case, diagnosis was difficult and depended on pathological conclusions. Clinically, the renal cell carcinoma manifested as an inflammatory process. The tumor was confined to the renal medulla without distension of the renal capsule and was difficult to differentiate from renal cell carcinoma because of its unusual location. The patient received a radical nephrectomy and died of multiple metastases six months after the surgery. Preoperative tissue diagnosis, such as needle biopsy, should be performed first when radiological findings are suggestive of collecting duct carcinoma to enable proper treatment planning and prolong patient survival. We presented the imaging and histopathological findings of this rare case and the literature was reviewed.