[Port site metastasis of primary adenocarcinoma of the renal pelvis after a laparoscopic nephrectomy: a case report].
We report a case of port site metastasis of primary adenocarcinoma of the renal pelvis after a laparoscopic nephrectomy. A 76-year-old woman was admitted to our hospital with a complaint of anorexia, general malaise and left abdominal distension. Computed tomography revealed severe hydronephrosis in the left kidney. Laboratory examination revealed a high serum level of CA19-9 (155 U/ml). However, antegrade and retrograde pyelography revealed no filling defects and urine cytopathology for renal pelvis showed no malignancy. Thus, on the suspicion of a ureteropelvic junction stenosis, a laparoscopic nephrectomy was performed. There were some papillary tumors in the renal pelvis and a histopathological examination of the tumor revealed a papillary adenocarcinoma. Twelve months after nephrectomy, left iliopsoas muscle metastasis was found. Thus irradiation therapy with a total of 30 Gy was performed. However, 3 months later, the patient developed metastasis at the trocar site and the serum level of CA19-9 elevated to 6,720 U/ml. She died of multiple metastases from adenocarcinoma of the renal pelvis 4 months after port site metastasis.
Kobori
Yoshitomo
Y
Department of Urology, Nagano Red Cross Hospital.
Shigehara
Kazuyoshi
K
Amano
Toshiyasu
T
Takemae
Katsuro
K
D000009:Abdominal Muscles; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood; D003952:Diagnostic Imaging; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D007682:Kidney Pelvis; D010535:Laparoscopy; D019042:Muscle Neoplasms / Q000556:secondary*; D009392:Nephrectomy; D016658:Psoas Muscles; D013997:Time Factors
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen