肾盂输尿管癌肉瘤(附三例报告)

Carcinosarcoma of ureter and renal pelvis (report of 3 cases)

目的 总结肾盂输尿管癌肉瘤的临床及病理特点。 方法 报告 3例肾盂、输尿管癌肉瘤病例资料。 3例均为女性 ,年龄分别为 4 3、5 7、75岁。均以肉眼血尿或伴有腰痛就诊 ,经影像学检查诊断为肾盂输尿管肿瘤。 结果 2例行患肾、输尿管全长切除和膀胱部分切除术 ,1例行姑息性肿瘤切除术。病理检查发现为同时存在癌与肉瘤成分。 3例患者术后均未行放化疗 ,分别于术后 8个月 ,14个月和 2个月死于肿瘤转移。 结论 此病临床罕见 ,预后极差 ,诊断依靠病理学检查 ,免疫组化对确诊有重要价值 ,病理诊断应与肉瘤样癌相鉴别。

Objective To present the clinical and pathological features of carcinosarcoma of ureter and renal pelvis. Methods Three cases of carcinosarcoma of ureter and renal pelvis were reviewed. Results The clinical symptoms of carcinosarcomas of ureter and renal pelvis are hematuria and flank pain.The neoplasm consists of an admixture of malignant epithelial and mesenchymal elements on histological studies.The immunohistochemical studies demonstrated obvious epithelial and mesenchymal reactivity.Three patients died of the disease 8 months,14 months and 2.5 months after operation. Conclusions Carcinosarcoma of ureter and renal pelvis is a rare occurrence and is usually associated with a poor prognosis.It is sometimes difficult to make certain the diagnosis and the immunohistochemical studies are essential in pathological examinations.This lesion should be differentiated from sarcomatoid carcinoma.