Urinary tract tumor skin metastases
Introduction
Introduction to skin metastasis of urinary tract tumors Uninarytracttumors, 4.5% of skin metastases are derived from the kidney, and 8.2% are from the bladder. Skin metastases from kidney cells and excessive cell tumors are either locally metastatic (often on surgical scars) or metastatic. Metastatic cancer (adrenal adenoma) from renal cell carcinoma, common in the head and neck. Transitional cell carcinoma is common in the trunk and limbs. basic knowledge The proportion of illness: 0.005% Susceptible people: no special people Mode of infection: non-infectious Complications: skin cancer
Cause
Urinary tract tumor skin metastasis
(1) Causes of the disease
The cause is still unknown.
(two) pathogenesis
The pathogenesis is still unclear.
Prevention
Urinary tract tumor skin metastasis prevention
1 Minimize infection and avoid exposure to radiation and other harmful substances, especially drugs that have an inhibitory effect on immune function.
2 Appropriate exercise, enhance physical fitness and improve your disease resistance.
Mainly for the prevention of various factors that may lead to urinary tract tumors. It is currently believed that the loss of normal immune surveillance function, the tumorigenic effect of immunosuppressants, the activity of latent viruses and the long-term application of certain physical (such as radiation), chemical (such as anti-epileptic drugs, adrenocortical hormone) substances, Lead to the proliferation of lymphatic network, and eventually urinary tract tumors. Therefore, pay attention to personal and environmental hygiene, avoid drug abuse, and pay attention to personal protection when working in a harmful environment.
Complication
Urinary tract tumor skin metastasis complications Complications skin cancer
Complications are mainly skin lesions at the site of tumor metastasis, and specific complications vary depending on the condition. Transitional cell carcinoma Skin metastases, usually one or more flesh-colored dermal nodules. Verrucous papules and inflammatory plaques are less common skin metastases.
Symptom
Urinary tract tumor skin metastasis symptoms Common symptoms Endometriosis papules skin metastasis without sweat gland ductal keratin... Granuloma implanted nodular inflammatory cell infiltration nodules
Skin metastases from kidney cells and excessive cell tumors either locally metastasized (often on surgical scars) or distant metastases, metastatic carcinomas from renal cell carcinoma (adrenal adenomas), common in the head and neck, transitional cells Cancer is common in the trunk and limbs.
Renal cell metastasis is a single or extensive dermal nodule, the color is flesh-colored, especially purple, with obvious vascular distribution, as seen in kaposi sarcoma or suppurative granuloma, transitional cell carcinoma, skin metastasis, usually a Or multiple flesh-colored dermal nodules, verrucous papules and inflammatory plaques are less common skin metastases.
Examine
Examination of skin metastasis of urinary tract tumors
Histopathology:
Renal cell carcinoma is a clear cell adenocarcinoma. The metastatic nodules in the dermis are composed of large, polygonal cells with cytoplasmic transparency to fine granules. The nucleus is located in the center, and there are few polymorphisms. The cells are arranged in pieces and cords. Adenoid structure, the tumor is embedded in a thin, highly vascular interstitial with some red blood cell extravasation and hemosiderin deposition.
Skin metastases of transitional cell carcinoma are composed of large, oval cells with well-differentiated small amounts of basophilic to transparent cytoplasm. The nucleus has a certain pleomorphism, and a number of mitotic figures can be seen.
Special staining and immunohistochemistry:
Renal cell carcinoma contains intracytoplasmic lipids and glycogen (PAS-positive and amylase-sensitive), compared with clear-cell sweat gland cancer, which has no lipids, compared with sebaceous gland tumors, the latter with little or no glycogen, immune Peroxidase test, renal cell carcinoma cell keratin and epithelial membrane antigen positive, 70% of cases carcinoembryonic antigen and S-100 protein negative, and generally CEA positive primary clear cell sweat gland cancer and derived from lung and Cancer or metastatic cancer of other organs, as well as S-100 protein-positive clear cell melanoma.
Diagnosis
Diagnosis and diagnosis of urinary tract tumor skin metastasis
diagnosis
According to clinical manifestations, the characteristics of skin lesions and histopathological features can be diagnosed. The following points should be noted:
1. Clinically short-term (6 to 12 months) rapid growth of tumor nodules, distributed in the vicinity of the primary tumor surgery area or the corresponding lymphatic drainage area, and its histopathological morphology is similar to the primary tumor, especially When it is characterized by multiple or multifocal tumors, it should be considered as metastatic cancer of the skin.
2. Tumor plugs are found in the skin or subcutaneous fat vessels or lymphatic vessels. The distribution configuration of the cancer is narrow and trapezoidal at the bottom, generally not connected with the epidermis, there is very little inflammatory cell infiltration around the tumor cells, and no sweat gland ductal keratin membrane Differentiation, etc., are often characteristic of metastatic skin tumors.
3. It is helpful to distinguish by means of immunohistochemical markers. For example, the tumor originated from the sweat gland-derived tumor is positive for GCDFP-15, while the tumors of the prostate and thyroid metastasized to the skin are positive for PSA and TG, respectively. In addition, metastatic skin in the umbilical cord Nodules must be excluded from endometriosis or implanted nodules, and should also be distinguished from yolk sac or urinary tract embryo residues.
Differential diagnosis
Should be differentiated from kaposi sarcoma or pyogenic granuloma, transitional cell carcinoma skin metastasis.
