Gamze ERKILINÇ, Sema BİRCAN, Şirin BAŞPINAR, Şehnaz EVRİMLER, Altuğ ŞENOL, Onur ERTUNÇ, Bülent ÇETİN

RENAL HÜCRELİ KARSİNOMUN MİDEYE METASTAZI: OLGU SUNUMU

Primer mide tümörlerine, metastatik tümörlerinden daha sık rastlanır. Berrak hücreli renal hücreli karsinomun (BHRHK) mideye metastazı çok nadirdir. Bu yazıda BHRHK’un mideye metastazı olgusunu sunduk. Altmış yaşında erkek hasta radikal nefrektomi geçirdi ve adjuvan kemoterapi aldı. Takibinde ikinci yılda pulmoner metastaz izlendi ve relaps için interferon alfa- 2a kullanıldı. Akciğer metastazlarından iki yıl sonra dispepsi ile başvuran hastanın bilgisayarlı tomografik incelemesinde mide duvarında (boyunca) 11 mm kalınlık saptandı. Endoskopik inceleme nöroendokrin tümörü düşündürdü. Histopatolojik incelemede berrak vakuolize sitoplazmalı solid paternde tümöral hücre grupları gözlendi. Tümör hücreleri RCC, PAX8, CD10, Vimentin ile pozitif olup immünhistokimyasal sonuçlar ilk tümör ile benzerdi. Sonuç olarak olguya BHRHK’un mide metastazı tanısı verildi ve çok hedefli bir reseptör tirozin kinaz inhibitörü ile tedavi edildi.

Anahtar Kelimeler:

mide metastazı, berrak hücre, renal karsinom, immünhistokimya

GASTRIC METASTASIS OF RENAL CELL CARCINOMA: A CASE REPORT

Primary gastric tumors are encountered more frequently than metastatic tumors. The gastric metastasis of clear cell renal cell carcinoma (CCRC) is very rare. We herein report a case of gastric metastasis of CCRC. A sixty-year-old man patient underwent a radical nephrectomy and received adjuvant chemotherapy. Pulmonary metastasis occurred at the second-year follow-up, and interferon alpha-2a was used for relapse. The Computed Tomography examination of the patient presented with dyspepsia two years after pulmonary metastases revealed 11 mm thickness in the (along) gastric wall. Endoscopic examination was suggestive of a neuroendocrine tumor. Histopathologic evaluation of endoscopic biopsies showed tumoral cell groups in a solid pattern composed of clear, vacuolated cytoplasm. These tumor cells were positive for RCC, PAX8 CD-10, Vimentin, and immunohistochemistry findings were similar to the initial tumor at diagnosis. Finally, the patient was diagnosed with CCRC's gastric metastasis and treated with a multi-targeted receptor tyrosine kinase inhibitor.

Keywords:

gastric metastasis, clear cell, renal carcinoma, immunohistochemistry,

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