無原位腎臟腫瘤之轉移性乳突狀腎臟細胞癌
董劭偉1、何承勳1,2
1台北醫學大學附設雙和醫院 泌尿科，2台北醫學大學 泌尿科
Metastatic papillary renal cell carcinoma without primary renal tumor
Shao-Wei Dong1, Chen-Hsun Ho 1,2
1Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
2Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
A 56-year-old man with underlying of hepatitis B accompanied by acute abdominal pain this year.
He visited emergency department and abdominal and pelvic Computed Tomography (CT) scan accidentally found multiple paraaortic and retrocural lymph node enlargement suspected lymphoma and metastatic carcinoma with multiple metastatic lymphadenopathy.
We performed lymph node CT guide biopsy and laparoscopy lymph node dissection. Pathology showed the morphology and immunoprofile could be compatible with papillary renal cell carcinoma. And whole-body CT and Positron Emission Tomography scan showed large sellar mass with suprasellar extension and no other metastatic lesion. Due to the diplopia progressive was also noted, the patient underwent trans-sphenoidal surgery and pathology revealed pituitary adenoma. Renal CT guide biopsy was performed but pathology showed no renal cell carcinoma.
Papillary renal cell carcinoma accounts for about 10-15% of all renal cell carcinomas. There was much previously case report about papillary renal cell carcinoma. To our knowledge, this is the first reported case of metastatic papillary renal cell carcinoma without primary renal tumor.
This patient was received CABOMETYX ® 60mg QD (cabozantinib: receptor tyrosine kinase inhibitor with activity against MET, VEGFR2, FLT3, c-KIT, and RET) and close follow up at our out-patient department.