肾结石并肾盂黏液腺癌(附1例报告并文献复习)

Clinical characteristics of renal calculi concomitant with renal pelvicmucinous carcinoma

目的探讨肾结石合并肾盂黏液腺癌的发病机制及临床特征。方法报告1例肾结石并肾盂黏液腺癌患者的临床资料,患者行肾及输尿管全长切除术,术后病理报告为黏液腺癌。结合相关文献复习并对本病组织发生、临床特点等进行讨论。结果术后随访6个月,未见肿瘤转移及复发。结论结石并肾盂癌临床表现无特异性,术前诊断率低。结石病史长,反复合并感染者应警惕合并肾盂癌。CT有助于提高其诊断率。影像学检查显示肾脏囊性包块,囊壁不光滑,囊壁部分钙化,囊内液体密度不均,应考虑黏液腺癌可能。尿液中或肾内发现黏液提示肾盂黏液腺癌。肾盂黏液腺癌确诊依赖病理检查。肾盂黏液腺癌应行患侧肾输尿管全长切除术。没有证据表明术后化疗或放疗能改善患者预后,其预后难以估计。

Objective To study the pathogenesis and clinical feature of renal calculi concomitant with renal pelvic mucinous carcinoma.Methods We reported a case of renal calculi concomitant with renal pelvic mucinous carcinoma,a brief review of relevant literature was also presented.Results Pathological report was mucinous adenocarcinoma.No recurrence or metastasis was noted during 6 months follow-up.Conclusions There are no specific manifestations in the cases of renal calculus concurrence with carcinima of pelvis.Seldom cases can be accurately diagnosis before operation.For the cases with a long history of renal calculus and repeat infection,doctor should not ignore the concomitant renal pelvis tumor.CT scan is helpful to diagnose renal calculus concurrence with carcinima of pelvis.Medical image of large renal cystic mass with uneven or calcific wall and homogeneous cystic fluid may suggest renal pelvic mucinous carcinoma.Mucus in the urine or kidney implies renal pelvic mucinous carcinoma.Histological analysis is essential to establish the diagnosis.Radical nephrectomy and total ureterectomy is the treatment for this type of malignant tumor.No evidence manifests postoperative chemotherapy and radiation treatment might help to improve the prognosis.Prognosis was difficult to evaluate in the cases with mucinous carcinoma of the renal pelvis.