| 刘祥强,侯四川.以巨大肾转移瘤为首发表现的十二指肠球部印戒细胞癌一例[J].安徽医药,待发表. |
| 以巨大肾转移瘤为首发表现的十二指肠球部印戒细胞癌一例 |
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| 投稿时间：2025-07-01 录用日期：2025-08-11 |
| DOI： |
| 中文关键词: 原发性十二指肠癌 印戒细胞癌 肾鳞状细胞癌 转移性肾肿瘤 肾结石 |
| 英文关键词: |
| 基金项目:山东省医药卫生科技发展计划项目(编号：2019WS152) |
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| 中文摘要: |
| 摘要 目的 报道1例以巨大肾转移瘤为首发表现的罕见十二指肠球部印戒细胞癌（Signet-Ring Cell Carcinoma, SRCC）病例，旨在提升临床医生对该疾病的认识。方法 回顾性分析青岛市市立医院泌尿外科2024年10月收治的一例以巨大肾转移瘤及腰痛为首发表现的十二指肠球部SRCC患者的临床资料。结果 58岁男性，因发现左肾占位，初步诊断为肾鳞状细胞癌（Renal Squamous Cell Carcinoma, RSCC），行左肾根治性切除及右肾穿刺造瘘术，术后病理提示左肾低分化腺癌，免疫组化提示CDX2、CK20呈阳性；修正诊断为左肾转移性腺癌（肠源性）。后续行胃肠镜检查发现其十二指肠球部溃疡性病变，活检证实为SRCC。影像学提示全身多处转移，予以患者口服卡培他滨化疗联合局部放疗，末次随访至2025年5月，患者因疾病进展去世。结论 本文报道首例以巨大肾转移瘤为首发表现的十二指肠球部SRCC。该病发病率低、恶性程度高、早期症状缺乏特异性，诊断困难且预后极差。临床医生需提高对该罕见病的警惕性。 |
| 英文摘要: |
| Abstract Objective To report a rare case of duodenal bulb signet-ring cell carcinoma (SRCC) initially presenting as a giant renal metastasis, enhancing clinical awareness of this entity. Methods We retrospectively analyzed clinical data from an SRCC patient admitted to Qingdao Municipal Hospital Urology Department (October 2024) presenting with giant renal metastasis and lumbar pain as initial manifestations. Results A 58-year-old male patient was admitted with the detection of a left renal space-occupying lesion, and was initially diagnosed with renal squamous cell carcinoma (RSCC). He underwent radical left nephrectomy and right nephrostomy. Histopathology revealed poorly differentiated adenocarcinoma; immunohistochemistry demonstrated CDX2 and CK20 positivity, establishing metastatic adenocarcinoma of intestinal origin. Subsequent endoscopy identified duodenal bulb ulcerations confirmed as SRCC on biopsy. Imaging confirmed systemic metastases. Treatment comprised oral capecitabine with local radiotherapy. The patient succumbed to disease progression by final follow-up (May 2025). Conclusion This study reports the first case of duodenal bulb SRCC presenting with a giant renal metastasis. Characterized by low incidence, high-grade malignancy, and non-specific early symptoms, it presents significant diagnostic challenges and the prognosis remains grave. Heightened clinical vigilance for this entity is imperative. |
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