A 77-year-old man on systemic chemotherapy against postoperative bilateral multiple lung metastases of malignant solitary fibrous tumor of the pleura suffered from pruritus and jaundice. Blood examination showed eleva...A 77-year-old man on systemic chemotherapy against postoperative bilateral multiple lung metastases of malignant solitary fibrous tumor of the pleura suffered from pruritus and jaundice. Blood examination showed elevated levels of hepatobiliary enzymes. Abdominal computed tomography showed a tumor with peripheral enhancement in the pancreatic head, accompanied with the dilatation of intra- and extra-hepatic bile ducts. He was diagnosed as having obstructive jaundice caused by a pancreatic head tumor. The pancreatic head tumor was presumably diagnosed as the metastasis of malignant solitary fibrous tumor of the pleura, because the findings on the pancreatic head tumor on abdominal CT were similar to those on the primary lung lesion of malignant solitary fibrous tumor of the pleura. The pancreatic tumor grew rapidly after the implantation of metallic stent in the inferior part of the common bile duct. The patient died of lymphangitis carcinomatosa of the lungs. Autopsy revealed a tumor that spread from the pancreatic head to the hepatic hilum. Microscopically, spindle-shaped cells exhibiting nuclear atypicality or division together with collagen deposition were observed. Immunohistochemically the pancreatic head tumor cells were negative for staining of α-smooth muscle actin （α-SMA） or CD117, but positive for vimentin, CD34 and CD99. These findings are consistent with those on malignant solitary fibrous tumor of the pleura. We report the first case of obstructive jaundice caused by a secondary pancreatic tumor from malignant solitary fibrous tumor of the pleura.展开更多
BACKGROUND Secondary jejunal tumor from renal cell carcinoma(RCC)is extremely rare in clinical practice and is easily missed and misdiagnosed because of the low incidence and atypical symptoms.CASE SUMMARY A 38-year-o...BACKGROUND Secondary jejunal tumor from renal cell carcinoma(RCC)is extremely rare in clinical practice and is easily missed and misdiagnosed because of the low incidence and atypical symptoms.CASE SUMMARY A 38-year-old male patient was diagnosed pathologically with left RCC after radical nephrectomy in 2012.The patient then suffered multiple lung metastases 2 years later and was treated with oral sorafenib without progression for 6 years.In 2020,an emergency intestinal segmental resection due to intestinal obstruction was required,and postoperative pathology confirmed a jejunal secondary tumor from RCC.The patient had a smooth recovery following surgery.Three months after surgery,the patient was diagnosed with left adrenal metastasis,and subsequent sintilimab therapy has stabilized his condition.CONCLUSION This report is written to remind urologists and pathologists of the potential for small intestinal secondary tumors when a patient with a history of RCC seeks treatment for digestive symptoms.Enteroscopy and abdominal contrast-enhanced computed tomography are essential means of examination,but severe cases require immediate surgical intervention despite the lack of a preoperative examination to distinguish tumor attributes.展开更多
文摘A 77-year-old man on systemic chemotherapy against postoperative bilateral multiple lung metastases of malignant solitary fibrous tumor of the pleura suffered from pruritus and jaundice. Blood examination showed elevated levels of hepatobiliary enzymes. Abdominal computed tomography showed a tumor with peripheral enhancement in the pancreatic head, accompanied with the dilatation of intra- and extra-hepatic bile ducts. He was diagnosed as having obstructive jaundice caused by a pancreatic head tumor. The pancreatic head tumor was presumably diagnosed as the metastasis of malignant solitary fibrous tumor of the pleura, because the findings on the pancreatic head tumor on abdominal CT were similar to those on the primary lung lesion of malignant solitary fibrous tumor of the pleura. The pancreatic tumor grew rapidly after the implantation of metallic stent in the inferior part of the common bile duct. The patient died of lymphangitis carcinomatosa of the lungs. Autopsy revealed a tumor that spread from the pancreatic head to the hepatic hilum. Microscopically, spindle-shaped cells exhibiting nuclear atypicality or division together with collagen deposition were observed. Immunohistochemically the pancreatic head tumor cells were negative for staining of α-smooth muscle actin （α-SMA） or CD117, but positive for vimentin, CD34 and CD99. These findings are consistent with those on malignant solitary fibrous tumor of the pleura. We report the first case of obstructive jaundice caused by a secondary pancreatic tumor from malignant solitary fibrous tumor of the pleura.
文摘BACKGROUND Secondary jejunal tumor from renal cell carcinoma(RCC)is extremely rare in clinical practice and is easily missed and misdiagnosed because of the low incidence and atypical symptoms.CASE SUMMARY A 38-year-old male patient was diagnosed pathologically with left RCC after radical nephrectomy in 2012.The patient then suffered multiple lung metastases 2 years later and was treated with oral sorafenib without progression for 6 years.In 2020,an emergency intestinal segmental resection due to intestinal obstruction was required,and postoperative pathology confirmed a jejunal secondary tumor from RCC.The patient had a smooth recovery following surgery.Three months after surgery,the patient was diagnosed with left adrenal metastasis,and subsequent sintilimab therapy has stabilized his condition.CONCLUSION This report is written to remind urologists and pathologists of the potential for small intestinal secondary tumors when a patient with a history of RCC seeks treatment for digestive symptoms.Enteroscopy and abdominal contrast-enhanced computed tomography are essential means of examination,but severe cases require immediate surgical intervention despite the lack of a preoperative examination to distinguish tumor attributes.
