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目的探讨肾透明细胞癌胰腺转移瘤的临床特点。方法分析复旦大学附属中山医院自2003-01-01至2009-05-31病理确诊肾透明细胞癌胰腺转移3例病人的临床资料。结果(1)肾透明细胞癌胰腺转移瘤的B超表现为低回声团块,难以与胰腺癌鉴别;而在CT动脉期可表现为增强病灶,又难以与神经内分泌肿瘤鉴别。(2)术后病理大体标本表现为边界清晰,切面灰黄,伴有灰红色坏死区域肿块。镜下为细胞质量多呈透明色的成片状排列。(3)1例病人术后11个月死亡,另2例病人随访至2009年5月,术后生存时间分别为21个月和2个月,现仍在继续随访中。结论肾透明细胞癌胰腺转移瘤的共同特点为B超表现为低密度团块,CT表现为动脉期明显增强病灶。术前诊断主要依靠既往病史及CT检查。根治性胰腺转移瘤切除术后生存状况仍难确定,通常认为若无复发、转移,则有望获得长期生存。
Objective To investigate the clinical features of renal clear cell carcinoma of pancreas metastases. Methods The clinical data of 3 cases of pancreatic metastasis of renal clear cell carcinoma pathologically confirmed by Zhongshan Hospital Affiliated to Fudan University from 2003-01-01 to 2009-05-31 were analyzed. Results (1) B-ultrasound of pancreas metastasis of renal clear cell carcinoma showed low echo mass, which was difficult to differentiate from pancreatic carcinoma. In CT arterial phase, it could be seen as enhanced lesion and difficult to distinguish with neuroendocrine tumor. (2) Postoperative pathological gross specimens showed a clear boundary, gray-white section, accompanied by gray-red necrosis area lumps. Under the microscope for the quality of the majority of transparent cells into a sheet of color arrangement. (3) One patient died after 11 months and the other two patients were followed up until May 2009. The survival time after operation was 21 months and 2 months respectively. The follow-up is still ongoing. Conclusions The common features of pancreas metastases in renal clear cell carcinoma are low density clumps of B ultrasound and obvious enhancement of CT in arterial phase. Preoperative diagnosis mainly depends on past medical history and CT examination. Radical resection of pancreatic metastases is still difficult to determine the survival status, usually considered without recurrence, metastasis, is expected to obtain long-term survival.