Rapid metachronous bladder metastasis of type 2 papillary renal cell carcinoma.

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Archive of clinical cases Pub Date : 2023-01-01 DOI:10.22551/2023.39.1002.10249
Ahmed Elabbady, Ryan Boudreau, Vahid Mehrnoush, Mona Salem, Ahmed Fahmy, Rawan Elabbady, Ahmed Kotb
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Abstract

Renal cell carcinoma (RCC) frequently spreads to distant organs like the lung, lymph nodes, bone, and liver. However, there have been some reports of RCC bladder metastasis. We present a case of a 61-year-old man presented with total painless gross hematuria. The patient had a history of right radical nephrectomy for papillary (type 2) RCC, high-grade, pT3a with negative surgical margins. There was no evidence of metastases on 6-month surveillance CT. After one-year post-operation, at this current admission, the cystoscopy discovered a solid bladder mass away from the trigone in the right lateral bladder wall. The resected bladder mass was metastatic papillary RCC with PAX-8 positive but GATA-3 negative on immunostaining. A positron emission tomography scan confirmed multiple lung, liver, and osseous metastases. This case report can highlight the importance of having bladder metastasis in RCC mind, although rare, and may necessitate the surveillance measures like urine analysis at more frequent interval and CT Urography instead of regular CT to detect the RCC metastatic bladder cancer at early stage.

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2型乳头状肾细胞癌快速异时性膀胱转移。
肾细胞癌(RCC)经常扩散到远处的器官,如肺、淋巴结、骨和肝。然而,也有一些关于肾细胞癌膀胱转移的报道。我们提出的情况下,一个61岁的男子提出了完全无痛肉眼血尿。患者曾因乳头状(2型)肾细胞癌行右侧根治性肾切除术,高级别,pT3a,手术切缘阴性。6个月CT监测未见转移迹象。术后一年后,在本次入院时,膀胱镜检查发现在右侧膀胱外侧壁有一个远离三角区的实性膀胱肿块。切除膀胱肿块为转移性乳头状RCC,免疫染色PAX-8阳性,GATA-3阴性。正电子发射断层扫描证实多发性肺、肝和骨转移。本病例报告强调了膀胱癌转移的重要性,尽管罕见,但可能需要更频繁的间隔尿液分析和CT尿路造影等监测措施来代替常规CT早期发现RCC转移性膀胱癌。
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