Clinical Oncology Letters
https://www.clinicaloncologyletters.com/article/5c7003ad0e882558468e6fd7
Clinical Oncology Letters
Relato de Caso

Progressão sistêmica de câncer esofágico na forma de doença metastática renal bilateral

Systemic progression of esophageal cancer in the form of bilateral renal metastasis

Hansen CA, Dettino AL, Prestes JC, Fanelli MF

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Resumo

Introdução: O tratamento do carcinoma esofágico localizado tem como base a cirurgia, ancorada na estratégia de terapia multimodal, associando-se quimioterapia ou quimiorradioterapia, neoadjuvante ou adjuvante; em não candidatos cirúrgicos, utiliza-se quimiorradioterapia radical. Infelizmente, cerca de 50% dos pacientes experimentam recidivas locais ou à distância, mesmo tratados com intuito curativo. Relato de caso: 51 anos, masculino, carga tabágica de 30 anos-maço e etilista, teve diagnóstico de carcinoma de células escamosas de esôfago médio. O estadiamento foi feito com PET-CT. Foi submetido à quimiorradioterapia inicial; na avaliação de resposta, apresentou achado tomográfico novo de nódulos renais bilaterais e a biópsia renal acusou carcinoma de células escamosas metastático. Foi exposto a duas linhas de tratamento quimioterápico após progressão sistêmica, evoluindo com perda de performance, progressão de doença e óbito. Conclusão: enfatiza-se caráter incomum de recidiva de câncer esofágico, na forma de metástases renais bilaterais, evoluindo com perda de função renal progressiva e óbito.

Palavras-chave

Neoplasias esofágicas, carcinoma de células escamosas, recidiva, metástase neoplásica, neoplasias renais

Abstract

Background: Surgery is the backbone of treatment for localized esophageal cancer. Chemotherapy or chemoradiation are other treatment modalities used in the form of neoadjuvant or adjuvant therapy; in patients that are not surgical candidates, definitive chemoradiation is the main form of treatment of that condition. Unfortunately,in half of esophageal cancer patients treated with curative intent, disease recurs, locally or systemically. Case report: a 51-yearold male patient, with a 30 pack-year smoking history and alcoholic, was diagnosed with a mid-esophageal squamous cell carcinoma. Staging was conducted with a PET scan. Chemoradiation was the initial form of treatment. One month after its completion, computed tomography detected bilateral renal nodules and pathology report revealed metastatic squamous cell carcinoma to the kidneys. The patient was treated with two chemotherapy protocols, finally experienced general decline, disease progression and death. Conclusion: this report highlights an unusual form of recurrence from esophageal cancer, with bilateral renal metastasis, culminating with kidney failure and death.

Keywords

Esophageal neoplasms, squamous cell carcinoma, recurrence, neoplasm metastasis, kidney neoplasms

Referências

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