前列腺癌伴肾细胞癌内转移1例报告

Metastasis of prostate cancer in renal cell carcinoma

前列腺癌肾转移极罕见。本文报道1例前列腺癌伴肾癌内转移患者的临床特征和诊治经过。患者,67岁。因腰背疼痛3个月,加重伴发热2周于2018年6月就诊,病理诊断为前列腺腺癌伴骨转移,Gleason评分4+4分,T2N0M1期。腹部CT检查示右肾下极肿物,约3.0 cm×2.5 cm×2.5 cm,动脉期明显强化,考虑右肾癌。行右肾部分切除术。术后病理检查示肾透明细胞癌Ⅱ级,肾癌组织内见多个小灶前列腺腺泡细胞癌浸润。术后诊断:转移性前列腺癌,右肾透明细胞癌。术后影像学随访18个月未见右肾肿瘤复发。患者的前列腺癌予药物去势和醋酸阿比特龙治疗,治疗6个月后出现PSA进展,先后予多西他赛化疗、锶89治疗,效果欠佳,随访至第30个月患者因恶液质死亡。

Prostate cancer with metastasis to the kidney is rare.Here,we report a case of prostate cancer metastasizing to renal cell carcinoma.A 67-year-old male presented with low back pain for 3 months,aggravated with persistent fever for 2 weeks in June 2018.Histopathological diagnosis of prostate adenocarcinoma was established.Meanwhile,contrasted CT of the abdomen showed a 3.0 cm×2.5 cm×2.5 cm enhanced solid mass on the lower pole of the right kidney.Nephron-sparing surgery was performed for the renal mass.Histopathology revealed a Grade 2 renal clear cell carcinoma with focal prostate carcinoma metastasis to the tumor.Then the patient received abiraterone acetate(AA)therapy.The patient did not encounter tumor recurrence in right kidney 18 months after surgery.However,PSA progression occurred 6 months later after AA therapy,then docetaxel chemotherapy and Sr89 therapy were performed with limited efficacy.The patient died after 30 months.