尿道憩室内肾源性腺瘤1例报告并文献复习

Nephrogenic adenoma in urethral diverticulum:a case report and literature review

目的探讨女性尿道憩室内肾源性腺瘤的临床特点及误诊原因。方法对我科收治的1例尿道憩室内肾源性腺瘤患者的临床资料进行回顾性分析,并复习相关文献。结果患者,女,56岁,主因“无痛性肉眼血尿6月余”入院。门诊行膀胱镜检查示膀胱颈乳头样肿物,因患者疼痛难忍而暂停检查,未见明显肿瘤根蒂。遂以“膀胱颈肿物”收治入院,后行经尿道膀胱肿物电汽化切除,术中发现乳头样肿物位于尿道憩室内,予以切除后病理结果提示肾源性腺瘤。术后留置导尿管1周后予以拔除,患者排尿未见明显异常,出院随访2个月,未见肿瘤复发及排尿异常。结论女性尿道憩室位置隐蔽,若憩室内肿瘤数量较多,堵塞憩室开口后极易与膀胱颈肿瘤混淆。

Objective To explore the clinical characteristics and causes of misdiagnosis of nephrogenic adenoma in urethral diverticulum. Methods The clinical data of 1 misdiagnosed case of nephrogenic adenoma in urethral diverticulum were analyzed retrospectively,and related literature was reviewed. Results A 56-year old woman was admitted to the hospital due to painless gross hematuria for 6 months.Papillary tumor was found in the neck of bladder during the examination of cystoscopy.But the base of tumor was indistinct as the blood of tumor and the pain which could not be borne by the patient.After the examination,the woman was diagnosed as the tumor of bladder neck primarily.Transurethral resection of bladder tumor was performed after several days.The papillary tumor was found in the urethral diverticulum during the operation.The pathology result of tumor after resection was nephrogenic adenoma.There was no obvious abnormality in urination after the catheter being pulled out after 7 days.During the follow-up period of 2 months,she had good prognosis without nephrogenic adenoma recurrence and abnormal urination. Conclusions The position of female urethral diverticulum was hidden,so we could not distinguish between the urethral diverticulum and bladder neck tumor easily if filled with tumor in diverticulum.