Carcinoma renal sarcomatoide con múltiples metástasis cutáneas
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v80i5.543Palabras clave:
Cancer renal, sarcomatoide, metastasis, factor sarcomatoide, pronósticoResumen
Descripción del caso clínico: Masculino de 47 años que presentó lesiones cutáneas nodulares rojo-violáceas en cara, cuero cabelludo y manos, biopsia con reporte de metástasis de tumor renal. Estado general conservado, masa palpable abdominal y microhematuria. Tomografía reportó tumor renal derecho infiltrando grasa perirrenal. Se realizó nefrectomía radical derecha, reporte histopatológico tumor de células claras con 60% de componente sarcomatoide. Inició sunitinib con involución de las lesiones cutáneas, tras 2 semanas de intermitencia presentó recurrencia modificándose la dosis. Tres meses después presentó actividad metastásica cerebral, hepática y ósea evolucionando tórpidamente, falleciendo a cinco meses del diagnóstico.
Relevancia: Particularmente nuestro caso no solo presenta una forma infrecuente de metástasis de cáncer renal recidivante a pesar del tratamiento con inhibidores de la tirosincinasa, sino también diferenciación sarcomatoide, una variante muy agresiva de cáncer renal.
Implicaciones clínicas: Las metastásis cutáneas de cáncer renal presentan una incidencia aproximada de 3%, si bien no es de buen pronóstico encontrarlas, su detección oportuna es primordial en todo paciente.
Conclusiones: El carcinoma renal sarcomatoide es un tumor raro y de pronóstico sombrío, generalmente asociado a metastásis a distancia. Es necesaria la valoración cutánea completa de todo paciente diagnosticado con cáncer renal para el adecuado estadiaje y tratamiento.
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