输尿管平滑肌肉瘤1例报道并文献复习

Leiomyosarcoma of the ureter:report of 1 case and review of the literature

目的 探讨输尿管平滑肌肉瘤的临床特点、病理学特点、治疗方法及预后。方法回顾性分析2017年4月本院收治的1例输尿管平滑肌肉瘤患者的临床资料,并结合文献复习讨论输尿管平滑肌肉瘤的临床表现、病理特点、诊疗方法及预后。结果患者为老年女性,主要表现为间断无痛性肉眼血尿5个月余,CT提示膀胱右后方占位性病变,行根治性右肾、右输尿管切除术。术后病理检查为右输尿管平滑肌肉瘤,肿瘤大小为10cm×2cm×1.8cm,术后患者恢复良好。结论输尿管平滑肌肉瘤临床罕见,为高度恶性间叶源性肿瘤,临床症状及影像学检查均无特异性,确诊需要依据术后病理检查。治疗主要以外科手术为主,放疗、化疗等辅助治疗效果尚不明确。

Objective To investigate the clinical features and pathological features of leiomyosarcoma of the ureter and the therapeutic methods. Method One case of leiomyosarcoma of the ureter in April 2017 was retospectively analyzed, and the clinical manifestation,pathologic characteristics, treatment and prognosis of leiomyosarcoma of the ureter was discussed with review of the literature. Result The patient was an older woman, complained of painless gross hematuria for more than five months. CT scan of the abdomen revealed a space occupying lesion arising from the right rear of the bladder. The patient underwent the radical resection of right kidney and ureter. The tumor size was 10 cm X 2 cm X 1.8 cm, and it was diagnosed as leiomyosarcoma of the ureter by postoperative pathologic diagnosis. The patient recovered uneventfully from the operation. Conclusion Leiomyosarcoma of the ureter is an extremely rare and highly malignant tumor.Clinical presentations and radiologic features are nonspecific and diagnosis is usually made by postoperative pathology. Radical excision being the primary treatment, the treatment effect of adjuvant chemotherapy and irradiation remains debatable.