RESUMO
We herein report an extremely rare case of intratumoral metastasis of colon cancer to chromophobe renal cell carcinoma. A 71-year-old woman was diagnosed with lung metastasis of sigmoid colon cancer and underwent sigmoid colon resection with D3 lymph node dissection. Preoperative contrast-enhanced computed tomography (CT) revealed a left renal tumor; however, colon resection was prioritized, and the renal tumor was placed under observation. Two years later, CT revealed enlargement of the left renal tumor, and laparoscopic partial left nephrectomy was performed 1 month later. Histopathologic examination showed that the resected renal tumor was a chromophobe renal cell carcinoma with intratumoral metastasis of colon cancer to the renal tumor center, and adjuvant chemotherapy with bevacizumab plus SOX (L-OHP + S-1) was initiated. Because of severe chemotherapy-induced fatigue and nausea, the patient was switched to bevacizumab + S-1. However, the patient's nausea did not improve after this change, and postoperative adjuvant chemotherapy was discontinued at the patient's request 4 months after the partial nephrectomy. Two months after discontinuation of chemotherapy, CT showed no renal recurrence; however, increased lung metastases and a new bone metastasis in the left sciatic bone were observed. Palliative treatment was then initiated because of severe adverse events that made it difficult to continue treatment. In patients who have multiple cancers and an increase in renal tumor size, the possibility of intratumoral metastasis to the renal tumor should be considered.
RESUMO
An 88-year-old man was treated with a urethral bougie after balloon dilation for urethral stricture in 2019. In December 2020, the patient was referred to our hospital with a fever and voiding disturbance. The patient was diagnosed with a urinary tract infection at the time of admission and was treated with an antibacterial agent. Candia glabrata was detected in both the blood and urine cultures obtained on admission. However, antifungal therapy was not administered because the blood culture was negative on reexamination. Sixteen days after admission, magnetic resonance imaging revealed an abscess in the corpus spongiosum. Cystostomy and abscess drainage were performed because the corpus spongiosum abscess was worsening. Candia glabrata was detected in the abscess; therefore, we treated the patient with antifungal therapy. After 14 days of antifungal agent treatment, the corpus spongiosum abscess disappeared. An abscess of the corpus spongiosum caused by candiduria is exceedingly rare; this is the first reported case in Japan.