腎盂鱗狀細胞癌併皮膚轉移之病例報告及文獻回顧

謝棨圳^1、2、耿俊閎^1、2、詹鎮豪^1、2、王巽玄^1、2、沈榮宗^1、2、曹曜軒^1、2、吳怡萱^1、2、李永進^1、2

¹高雄市立小港醫院 泌尿科；²高雄醫學大學附設中和紀念醫院 泌尿部

Skin Metastasis of Renal Pelvic Squamous Cell Carcinoma: A Case Report and Literature Review

Chi-Chun Hsieh^1,2, Jiun-Hung Geng^1,2, Jhen-Hao Jhan^1,2, Hsun-Shuan Wang^1,2, Jung-Tsung Shen^1,2, Yao-Hsuan Tsao^1,2, Yi-Hsuan Wu^1,2, Yung-Chin Lee^1,2

¹ Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan

² Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Introduction: Squamous cell carcinoma (SCC) accounts for less than 1% of renal tumor. It is believed that the carcinogenesis is related to chronic irritation to the renal parenchyma, such as nephrolithiasis, hydronephrosis or pyelonephritis. Metastasis of renal SCC to the skin is even more rare. We present a 48-year-old male with a progressive tumor on the skin of left flank.

Case presentation: A-48-year-old male with underlying disease of left renal stone disease and was treated with extracorporeal shock wave lithotripsy seven times and percutaneous nephrolithotomy three months ago. During recent one month, a rapidly growing, ulcerative tumor was noted on his left flank. He also complained of poor appetite, weight loss and intermittent fevers. Abdominal computed tomography and magnetic resonance imaging showed a mass measuring 8.5 cm with a sinus tract formation from the left kidney to the skin on the left flank. Tumor excision was performed and the pathology report revealed skin metastasis of renal SCC.

Conclusion: We described a rare case of skin metastasis of renal SCC with history of nephrolithiasis treated with extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. Due to the fierce behavior and poor prognosis, surgical resection and chemoradiotherapy are usually ineffective.