输尿管末端血管瘤误诊为膀胱肿瘤临床分析并文献复习

The Clinical Analysis of Distal Ureteral Hemangioma Misdiagnosed as Bladder Neoplasm and Literature Review

目的总结输尿管血管瘤的临床及影像学特征,探讨其误诊原因及防范措施。方法回顾分析我院收治的误诊为膀胱肿瘤的输尿管末端血管瘤1例的临床资料,并复习相关文献。结果本例因间歇性、无痛性肉眼血尿1周入院,因临床表现及泌尿系CT、B超检查结果与膀胱肿瘤极为相似,误诊为膀胱肿瘤。经肿瘤切除术后病理检查证实为输尿管海绵状血管瘤。术后随访至今未见血尿及相关症状。结论输尿管血管瘤发病率低,临床及影像学表现缺乏特异性,术前诊断困难。全面综合分析病情、加强对特征性影像学表现认识、认真进行鉴别诊断可减少或避免输尿管血管瘤误漏诊,但最终确诊需依赖病理检查结果。

Objective To summarize the clinical and imaging characteristics of ureteral hemangioma, and explore the causes of misdiagnosis and the measures of prevention. Methods The clinical data of a patient with distal ureteral hemangio-ma misdiagnosed as bladder neoplasm in our hospital was retrospectively analyzed, and related literature was reviewed. Re-sults The patient was admitted for intermittent and painless gross hematuria for one week. The clinical manifestations, urina-ry tract CT and ultrasound results were similar to bladder neoplasms, so the patient was misdiagnosed as having bladder tumor. Postoperative pathological examination showed ureteral cavernous hemangioma, and no gross hematuria and related symptoms occurred in the follow-up. Conclusion The preoperative diagnosis of ureteral hemangioma is difficult for its low incidence and unspecific clinical and imaging characteristics. Comprehensive analysis of the disease, enhancing the understanding of the characteristics of imaging performances and carrying out the differential diagnosis may reduce or avoid the misdiagnosis of ure-teral hemangioma. But confirmed diagnosis mainly depends on the postoperative pathology.