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本文报道一例不同来源的肺部多发性癌转移的治疗经验,文献中尚无类似报道,冀对外科临床有一定的参考价值。患者男性、53岁,因间歇性腹部绞痛、伴恶心、呕吐数日,经检查发现明显贫血,大便隐血3+、钡剂灌肠示升结肠有一个似苹果轴心样的狭窄区,诊断为升结肠癌。同时又作静脉肾盂造影、超声波检查发现右肾有一囊性肿块,符合肾肿瘤。胸片正常,肝、脾扫描无转移病灶之证据。乃决定作右肾切除和右半结肠切除术。病理报告:右肾透明细胞癌,肾动静脉内均无肿癌细胞,输尿管切缘阴性、3只淋巴结无转移,右侧肾上腺未果及;右侧结肠腺癌、分化良好、部份为粘液性,肿瘤穿透肠壁全层。21只淋巴结中仅1只阳性。术后恢复顺利;8天后出院。术后三个月,胸部X片随访,发现右下肺转移性结节,遂行右下肺楔形切除,病理证实为转移性肾癌。尔后胸
This article reported one case of different sources of lung cancer metastasis treatment experience, there is no similar report in the literature, sputum has a certain reference value for surgical clinic. The patient was a 53-year-old man with intermittent abdominal cramps, nausea, and vomiting for several days. He was found to have obvious anemia after examination. The stool occult blood 3+ and barium enema showed that there was an apple-like axis in the ascending colon and was diagnosed as l Colon cancer. At the same time for intravenous pyelography, ultrasound examination revealed a cystic mass in the right kidney, consistent with renal tumors. Chest radiographs were normal, and liver and spleen scans had no evidence of metastatic lesions. It was decided to perform right kidney resection and right hemicolectomy. Pathology report: Clear renal cell carcinoma of the right kidney, no tumor cells in the renal arteriovenous vein, negative ureteral margin, no lymph node metastasis, uncorrected right adrenal gland, right colon adenocarcinoma, well-differentiated, partially mucinous The tumor penetrates the entire wall of the intestinal wall. Only 1 out of 21 lymph nodes were positive. She recovered smoothly after surgery; she was discharged 8 days later. Three months after operation, the chest X-rays were followed up and metastatic nodules in the right lower lung were found. The right lower lung wedge was removed and pathologically confirmed as metastatic renal cell carcinoma. After the chest