대장과 근육으로 전이한 신세포종

초록

Although metastasis is relatively frequent in renal cell carcinoma (RCC), mainly to the lung, lymph nodes, liver and bones, adrenal glands, and the opposite kidney, location of metastasis in muscles or colon is extremely rare. The literature only offers isolatede cases of RCC with metastasis in colon or muscles but simultaneous colonic and muscular metastases have not reported. According to the reported cases, no preferred muscular site is found nor is there any clearintrinsic relation to prognosis. We report a case of pathologically proven simultaneous colonic and muscular metastasis in the abdominal wall. The patient was a 74 year old woman who had undergone a left radical nephrectomy 4 years ago previously for RCC (clear cell type, grade 2) presented with general weakness. Abdominal CT scan revealed a large hematoma-like mass in left renal bed and anothler small mass in the left abdominal wall. Resected specimen was a product of left hemicolectomy and a 3.5cm sized ovoid tumor nodule from the abdominal wall. The colonic mucosa showed 10cm sized large hemorrhagic polypoid mass penetrating the colonic wall with exophytic mass formation. Cut surface showed diffuse severe hemorrhage, necrosis and focal yellow spots. Microscopically the colonic and abdominal wall mass showed clear cell RCC, grade 2 by Fuhrman.