Retka mesta metastatskog karcinoma bubrežnog parenhima

  • Novak Milović Department of Urology, Military Medical Academy, Belgrade, Serbia, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Miodrag Lazić Department of Urology, Medical Center „Dr Dragiša Mišović-Dedinje“, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Predrag Aleksić Department of Urology, Military Medical Academy, Belgrade, Serbia, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Dragan Radovanović Department of Surgery, Medical Center „Dr Dragiša Mišović-Dedinje“, Belgrade, Serbia
  • Vladimir Bančević Department of Urology, Military Medical Academy, Belgrade, Serbia, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Slaviša Savić Department of Urology, Medical Center „Dr Dragiša Mišović-Dedinje“, Belgrade, Serbia;
  • Dušica Stamenković Department of Anesthesia and Intensive Care, Military Medical Academy, Belgrade, Serbia
  • Dušan Spasić Department of Surgery, Medical Center „Dr Dragiša Mišović-Dedinje“, Belgrade, Serbia
  • Branko Košević Department of Urology, Military Medical Academy, Belgrade, Serbia
  • Mirko Jovanovic Military Medical Academy, Urology Clinic
  • Dragoljub Perović Clinic of Urology and Nephrology, Clinical Center of Montenegro, Podgorica, Montenegro
DOI: https://doi.org/10.2298/2008
Ključne reči: carcinoma, renal cell||, ||karcinomi bubrežnog parenhima, neoplasm metastasis||, ||neoplazme, metastaze, urologic surgical procedures||, ||hirurgija, urološka, procedure, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Tumori bubrežnog parenhima (renal cell carcinoma – RCC) čine 3% maligniteta odraslih osoba. Najčešća lokalizacija metastaza RCC je u plućima, limfnim žlezdama, jetri i kostima, ali se u retkim slučajevima nalaze i u drugim organima. Prikaz bolesnika. Dve godine nakon radikalne levostrane nefrektomije zbog RCC, 63-godišnjem bolesniku je učinjena limfadenektomija zbog metastaze RCC u paraaortalnu limfnu žlezdu. Deset meseci kasnije, učinjena je levostrana hemikolektomija zbog metstaze RCC u rektosigmoidni kolon. Kod drugog bolesnika, starog 37 godina, dve godine nakon levostrane radikalne nefrektomije zbog RCC, urađena je parcijalna desnostrana nefrektomija. U daljem periodu praćenja bolesnika, urađeno je više hirurških zahvata u cilju uklanjanja metastaza iz različitih organa: metastazektomija pluća, resekcija tankih creva i cekuma, i desnostrana orhiektomija. Dve godine nakon primarnog hirurškog zahvata došlo je do letalnog ishoda usled širenja bolesti na koštani sistem i mozak. Treći bolesnik, star 35 godina, nakon desnostrane nefrektomije zbog metastatskih promena RCC u limfnim žlezdama prošao je kroz limfadenektomije 6, 12 i 24 meseca nakon primarne operacije. Kod istog bolesnika četiri godine nakon primarne operacije, učinjena je desnostrana hemikolektomija zbog metastatske promene RCC u cekumu. Zaključak. Praćenje bolesnika nakon nefrektomije zbog RCC uz korišćenje metoda snimanja u određenim vremenskim intervalima doprinosi pravovremenom otkrivanju metastaza. Primena odgovarajućeg hirurškog zahvata u ranoj fazi poboljšava produžavanja i popravlja kvalitet života bolesnik.

Biografija autora

Novak Milović, Department of Urology, Military Medical Academy, Belgrade, Serbia, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Dept of Urology

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Objavljeno
2017/01/20
Broj časopisa
Vol. 70 Br. 9 (2013)
Rubrika
Prikaz bolesnika