上尿路内翻性乳头状瘤7例报告

Inverted papilloma of the upper urinary tract (Report of 7 cases)

目的:探讨上尿路内翻性乳头状瘤(IP)的临床特征.方法:回顾分析7例上尿路IP患者的临床资料.患者多以无痛性肉眼血尿就诊,影像学检查提示上尿路占位性病变.术中冷冻切片确诊.5例行肾、输尿管全长切除,2例输尿管肿瘤分别作局部及节段切除.结果:术后病理检查均证实为上尿路IP.7例随访19～85个月,无肿瘤复发、恶变.结论:上尿路IP是良性肿瘤,诊断主要依据影像学及内镜检查;治疗主要开放手术及内镜手术.其有易同时或异时并发泌尿系恶性肿瘤可能,术后随访十分重要.

Objective:To investigate the etiology, pathology, diagnosis and treatment of inverted papilloma of the upper urinary tract.Methods:The clinical data of 7 cases(all males, with a mean age of 65 years) of inverted papilloma of the upper urinary tract were analysed retrospectively. Most patients presented with hematuria. The intravenous urography (IVU) and retrograde pyelography (RGP) demonstrated filling defects. Space occupying lesions were found by B ultrasonography and CT scan in all patients. 3 cases occurred in the renal pelvis, and 4 in the ureter. All cases were diagnosed intraoperatively with the frozen section. 5 of them underwent nephroureterectomy. One had segmental excision of the papilloma at ureter, and one had local excision of the papilloma.Results:Postoperative pathology confirmed the diagnosis of inverted papilloma of the upper urinary tract. No recurrences and metastases were found during a follow-up of 19 to 85 months.Conclusions:Inverted papilloma of the upper urinary tract is a benign tumor, and there is a overwhelming male predominance. The diagnosis can be established mainly by urography, ultrasonography, CT and ureteroscope. It may be treated by open or endoscopic surgery. Although this disease has a good prognosis, regular follow-up is necessary for the reason that malignant lesion may be found simultaneously or allochrologically.