A case of gastric metastasis from renal cell cancer during the sequential targeted therapy.
A case of gastric metastasis from renal cell cancer during the sequential targeted therapy.
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序贯靶向治疗肾细胞癌胃转移一例。
DOI：
10.1007/s13691-017-0286-x
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Yonese J.
中科院分区：
文献类型：
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作者：
Uehara S;Yuasa T;Fujisaki J;Fujii Y;Yamamoto S;Masuda H;Fukui I;Yonese J.
从历史上看，肾细胞癌（RCC）的胃转移非常罕见。然而，由于RCC目前正在接受各种靶向治疗药物的治疗，随着预后的改善和随访时间的延长，不寻常的内脏转移的发生率可能会增加。在这里，我们提出了一个有价值的情况下，从肾细胞癌胃转移检测在常规CT扫描序贯靶向治疗。一名73岁男性被转诊到我院，表现为左肾细胞癌伴多发性肺转移，cT1bN0M1期。他接受了舒尼替尼组成的一线靶向治疗，随后接受了左根治性肾切除术。然后，他接受了由干扰素α、舒尼替尼、依维莫司和阿西替尼组成的序贯治疗多发性肺转移。肾切除术后5年，随访计算机断层扫描显示胃中有一个2.2 × 1.6 cm的肿块，无任何症状。胃肠内视镜检查发现胃底有一息肉样病变。进行了内镜粘膜下切除术。显微镜下诊断为RCC胃转移。在这个靶向治疗的时代，随着各种新的治疗药物增加转移性RCC患者的生存期，临床医生必须注意胃中的转移，尽管这在以前是一种罕见的事件。
Historically, gastric metastasis from renal cell cancer (RCC) has been extremely rare. As RCC is now being treated with various agents of targeted therapy, however, the rate of unusual visceral metastases might increase as outcomes improve and follow-up periods grow longer. Here we present a valuable case of gastric metastasis from RCC detected in a routine CT scan during sequential targeted therapy. A 73-year-old man was referred to our hospital, presenting with left renal cell cancer with multiple lung metastases at stage cT1bN0M1. He received first-line targeted therapy consisting of sunitinib and subsequently underwent left radical nephrectomy. He then underwent sequential therapy consisting of interferon-alpha, sunitinib, everolimus, and axitinib for multiple lung metastases. Five years after nephrectomy, a follow-up computed tomography scan revealed a 2.2 × 1.6 cm mass in the stomach without any symptoms. Gastrointestinal endoscopy disclosed a polypoid lesion at the gastric fundus. Endoscopic submucosal resection was performed. Microscopic diagnosis revealed gastric metastasis from RCC. As various new therapeutic agents increase survival periods for metastatic RCC patients in this era of targeted therapy, clinicians must watch for metastasis in the stomach, though this was formerly a rare event.