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Cir. & cir ; 76(4): 339-342, jul.-ago. 2008. ilus
Artículo en Español | LILACS | ID: lil-568076

RESUMEN

BACKGROUND: Renal cell carcinoma (RCC) represents approximately 3% of malignant tumors in adults and occurs in a M:F ratio of 1.5:1.0. Although in most cases it occurs in persons 50 to 70 years of age, there are also reports in children. Clear cell carcinoma is the most frequent histological type, and 30% of renal carcinomas have metastasized at the time of diagnosis. The objective of the present study is to report colon metastasis of clear cell carcinoma that required surgery and chemotherapy. CLINICAL CASE: We report the case of a 60-year-old male with a history of metastatic RCC. His treatment consisted of cytoreductive radical nephrectomy and interferon because of pulmonary disease. He was followed-up for 8 years. Nevertheless, he presented with hematochezia and underwent colonoscopy where a splenic flexure tumor was demonstrated. Biopsy reported a clear cell tumor. We performed a left hemicolectomy. Pathology report was clear cell carcinoma with involvement of the colon from the mucosa to serosa. The patient again received interferon. Currently, there is no evidence of tumor activity and the patient is being followed-up. CONCLUSIONS: RCC metastases are most frequent in lung, liver, and bone and less frequent in brain, skin, and soft tissue. Metachromic metastases are identified in the first to second year after nephrectomy in most cases. Survival of patients who present metastasis <1 year after nephrectomy is 33 months vs. patients who present metastasis after 1 year from nephrectomy (55 months). Metastatic clear cell carcinoma requires surgery and immunotherapy. Surgery is the first step for disease control and metastatecomies are indicated in localized disease or when one organ is affected and surgically accessible.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Adenocarcinoma de Células Claras/secundario , Carcinoma de Células Renales/secundario , Neoplasias Renales/patología , Neoplasias del Colon/secundario , Adenocarcinoma de Células Claras/tratamiento farmacológico , Adenocarcinoma de Células Claras/cirugía , Antineoplásicos/uso terapéutico , Terapia Combinada , Carcinoma de Células Renales/complicaciones , Carcinoma de Células Renales/tratamiento farmacológico , Carcinoma de Células Renales/cirugía , Colectomía/métodos , Estudios de Seguimiento , Hemorragia Gastrointestinal/etiología , Inmunoterapia , Interferón-alfa/uso terapéutico , Nefrectomía/métodos , Neoplasias Pulmonares/secundario , Neoplasias Renales/tratamiento farmacológico , Neoplasias Renales/cirugía , Neoplasias del Colon/complicaciones , Neoplasias del Colon/tratamiento farmacológico , Neoplasias del Colon/cirugía , Inducción de Remisión
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