临床病例:原发性肾癌切除术后的骨转移瘤切除手术

Bryam Esteban Coello García, Galo Fernando Tulcanaza Ochoa, Sebastián Cardoso Gives, María José Sacoto Carrión, Leonardo Esteban Martínez Calderón, Gabriela Johanna Campoverde Mogrovejo, Diana Lorena Pedrosa Astudillo, Holger Xavier Rojas Espinoza, Maricarmen Vélez Chimbo, Carolina De Los Angeles Nuñez Galarza
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Bone metastasis is much more common than primary bone cancers, particularly in adults.\nObjective: to describe the present clinical case objectively and to make an analysis of the subject.\nMethodology: an objective description of the clinical case and a review with analysis of a total of 17 articles, including review and original articles, as well as clinical cases, of which 12 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: bone metastasis, bone tumor, oncologic surgery, renal carcinoma.\nResults: renal cell carcinoma represents about 2-3% of malignant neoplasms in adult individuals. Most of the cases occur between 50-70 years of age. 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引用次数: 0

摘要

简介骨是癌症转移的常见部位,癌症扩散到骨骼后,很少能治愈,但通常可以通过治疗阻止其扩散。骨转移比原发性骨癌要常见得多,尤其是在成人中。目的:客观描述本临床病例,并对该课题进行分析。方法:对临床病例进行客观描述,并对总共 17 篇文章(包括综述和原创文章以及临床病例)进行回顾分析,其中 12 篇参考文献被采用,因为其他文章与本研究无关。信息来源于PubMed、Google Scholar和Cochrane;搜索西班牙文、葡萄牙文和英文信息时使用的术语为:骨转移、骨肿瘤、肿瘤外科、肾癌。结果:肾细胞癌约占成人恶性肿瘤的2-3%。大多数病例发生在 50-70 岁之间。三分之一的肿瘤会发生转移(同步转移),另外三分之一的肿瘤会在未来出现转移(远期转移),甚至会在肾切除术后 20 年出现转移。肾细胞癌最常见的表现依次为:血尿(59%)、疼痛(41%)、发热(7%)、贫血(21%)和体重减轻(33%)。肾细胞癌的转移部位依次为肺(60%)、骨(20%)、肝(8%)、肾上腺和脑(5%),其他器官也可能受累:骨是常见的转移部位,所谓转移是指肿瘤细胞从原发肿瘤通过血行、淋巴或毗连途径转移到远处器官组织的能力。癌症扩散到骨骼后,虽然可以通过治疗阻止其扩散,但很少能治愈。目前,骨转移比原发性骨癌更为常见,尤其是在成年人中。肾细胞癌转移性骨病的临床治疗值得给予更多关注。在治疗骨转移患者时,需要采用多学科方法,而且每个患者的情况必须个体化,因为并非所有患者都能接受相同的手术或治疗。
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CLINICAL CASE, RESECTION OF BONE METASTASIS IN THE OLECRANON, AFTER EXCISION OF RENAL CARCINOMA OF PRIMARY ORIGIN
Introduction: Bone is a common site of metastasis, after cancer has spread to the bone, it can rarely be cured, however it can often be treated to stop its proliferation. Bone metastasis is much more common than primary bone cancers, particularly in adults. Objective: to describe the present clinical case objectively and to make an analysis of the subject. Methodology: an objective description of the clinical case and a review with analysis of a total of 17 articles, including review and original articles, as well as clinical cases, of which 12 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: bone metastasis, bone tumor, oncologic surgery, renal carcinoma. Results: renal cell carcinoma represents about 2-3% of malignant neoplasms in adult individuals. Most of the cases occur between 50-70 years of age. One third of the tumors metastasize (synchronous metastases) and another third manifest themselves in the future (metachronous metastases), even up to 20 years after nephrectomy. In order of manifestation, the most common findings in renal cell carcinoma are: hematuria (59%), pain (41%), fever (7%), anemia (21%) and weight loss (33%). In order of involvement, renal cell carcinoma metastasizes to the lung (60%), bone (20%), liver (8%), adrenal glands and brain (5%), and other organs can also be affected. Conclusions: Bone is a common site of metastasis, being called metastasis the capacity of a tumor cell to move from the primary tumor and adhere to tissues of a distant organ by hematogenous, lymphatic or contiguous route. After the cancer has spread to the bones, it can rarely be cured, although it can often be treated to stop its proliferation. Bone metastases are now much more common than primary bone cancers, particularly in adults. The clinical management of metastatic bone disease in renal cell carcinoma deserves more attention than it has been given so far. A multidisciplinary approach is required for the management of affected individuals with bone metastases, and each patients case must be individualized, since not all affected individuals can undergo the same surgical procedure or treatment. Key words: metastasis, cancer, bone, tumor, renal carcinoma.
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