肾盂鳞状细胞癌伴同侧输尿管鳞状细胞癌2例报告并文献复习  

Synchronous squamous cell carcinoma of the renal pelvis and squamous cell carcinoma of the ureter:report of two cases and review of literature

作　　者：陈壮飞[1] 郑少斌[1] 吴芃[1] 张鹏[1] 姜耀东[1] 赵善超[1] 毛向明[1] 陈泽荣[1] 单正飞[1] 

机构地区：[1]南方医科大学南方医院泌尿外科,广东广州510515

出　　处：《南方医科大学学报》2010年第12期2765-2767,共3页Journal of Southern Medical University

摘　　要：目的探讨肾盂鳞状细胞癌伴同侧输尿管鳞癌的临床病理特征。方法回顾性分析2例肾盂鳞癌伴同侧输尿管鳞癌患者的临床病理资料。病例1男,68岁,血尿1月入院,CT检查示右肾盂及输尿管下段占位,行根治性肾输尿管切除加膀胱袖套状切除术。病例2男,60岁,左腰部及左下腹痛1月外院诊断为左输尿管结石行输尿管切开取石术,术中见输尿管下段肿物,活检示鳞状细胞癌,转我院手术。术中见左肾下极肿物伴结肠侵犯,行根治性肾输尿管切除膀胱袖套状切除左半结肠切除及扩大淋巴结清扫术。2例患者术后均未行放化疗。结果病理报告病例1肾盂及输尿管均为中分化鳞癌,侵及肾盂黏膜下层及输尿管浅肌层。病例2肾盂中分化鳞癌,结肠受侵,输尿管下段低分化鳞癌,伴腹膜后淋巴结转移。分别于术后5个月和6个月死于肿瘤复发转移。结论肾盂鳞状细胞癌伴同侧输尿管鳞状细胞癌临床罕见,早期诊断困难,术后短期内易复发转移,预后极差。Objective To study the clinicopathological characteristics of synchronous squamous cell carcinoma （SCC） of the renal pelvis and SCC of the ureter. Methods The clinical data of two cases of synchronous SCC of the renal pelvis and SCC of the ureter were retrospectively reviewed and analyzed. In case 1,a 68-year-old man with hematuria for a month,imaging modalities revealed a right renal pelvis tumor and a right distal ureter tumor. The patient underwent nephroureterctomy and excision of the bladder cuff. Case 2,a 60-year-old man with the complaint of lower abdominal pain and left flank pain for a month,was diagnosed as left distal ureteral stone in another hospital. Reterolithotomy was performed and a ureteral tumor was found at the lower site of the stone intraoperatively. The pathological report demonstrated SCC,and the patient was transferred to our hospital for further treatment. We found a left renal mass invading the left hemicolon during surgery,and nephroureterectomy was performed with a bladder cuff excision,left hemicolon resection,and also complete lymph node dissection. Neither of patients received adjuvant radiotherapy/chemotherapy. Results Moderately differentiated SCC was reported in both of renal pelvis and ureter in case 1 and the tumor invaded the subepithelial connective tissue in the renal pelvis and superficial muscle in the ureter. In case 2,moderately differentiated SCC of the left renal pelvis with colon metastasis and poorly differentiated SCC of the ureter was reported with two retroperitoneal lymph node metastases. The two patients died from tumor recurrence and metastasis 5 and 6 months after the surgery,respectively. Conclusion Synchronous SCC of the renal pelvis and SCC of the ureter are rare and has high likeliness of early recurrence and metastasis,often with poor prognosis.

关 键 词：癌 鳞状上皮细胞 肾盂 输尿管 

分 类 号：R737.11[医药卫生—肿瘤]