肾癌晚期远处转移的额窦和眼眶肿瘤初始信号

Bojan Pavlovic,Sasa Jakovljevic,Katarina Jovanovic
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摘要

虽然副鼻窦转移极为罕见,但一旦发生转移,肾透明细胞癌是最常见的原发肿瘤。本文旨在介绍一例额窦和眼眶区域转移性透明细胞肾癌病例,该病例距最初诊断和治疗已有 7 年之久。患者因左眼睑下垂和左眼球移位而转诊至我院。计算机断层扫描显示,左侧额窦和眼眶有扩张性病变,导致其前壁、侧壁和顶壁遭到破坏。肿瘤和左眼眶的大量出血阻碍了对肿瘤向眼眶延伸情况和残余肿瘤大小的全面评估。因此,无法完全切除肿瘤,只能将肿瘤缩小。随后的组织病理学和免疫组化分析证实,该病灶是肾细胞癌在鼻窦道的转移。不幸的是,10 周后,患者离开了人世。转移性透明细胞肾癌的治疗取决于疾病的定位和患者的整体状况。如果是单发转移灶,如鼻窦部位,建议采用手术治疗。透明细胞肾癌转移到鼻窦部位的情况很少见,但如果肿瘤肿块生长迅速,通常伴有鼻衄和鼻塞等症状,则必须考虑这种情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Initial Frontal Sinus and Orbit Tumor Signaling Late Distant Metastasis in Kidney Cancer.
Although metastases to the paranasal sinuses are exceedingly rare, when they do occur, renal clear cell carcinoma is the most frequent primary tumor involved. The aim of this work was to present a case of metastatic clear cell renal carcinoma in the frontal sinus and orbit region, 7 years after the initial diagnosis and treatment. The patient was referred to our clinic due to drooping of the left eyelid and displacement of the left eyeball. Computed tomography revealed an expansive lesion in the left frontal sinus and orbit, causing destruction of its anterior, lateral, and roof walls. Profuse bleeding from the tumor and left orbit hindered a comprehensive assessment of tumor extension into the orbit and residual tumor size. Therefore, complete tumor removal was not possible; instead, reduction was achieved. Subsequent histopathologic and immunohistochemical analysis confirmed the lesion as a metastasis of renal cell carcinoma in the sinonasal tract. Unfortunately, 10 weeks later, the patient passed away. Treatment of metastatic clear cell renal carcinoma depends on the localization of the disease as well as the overall condition of the patient. If there is a solitary metastatic lesion, as in the case of the sinonasal region, surgical treatment is recommended. Metastasis of clear cell renal carcinoma to the sinonasal region is a rare occurrence; however, it is essential to consider it in cases of rapidly growing tumor masses, typically presenting with symptoms such as epistaxis and nasal obstruction.
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