肾细胞癌泌尿男性生殖道转移2例报告及文献复习  

Male genitourinary tract metastasis from renal cell carcinoma(Report of two cases and literature review)

作　　者：邓刚[1] 马立彬[1] 居翔 孟琦[1] 水冰[1] 徐如君[1] 于志坚[1] 

机构地区：[1]杭州市第一人民医院泌尿外科,杭州3100060

出　　处：《临床泌尿外科杂志》2014年第1期36-38,共3页Journal of Clinical Urology

基　　金：浙江省自然科学基金(编号Y2111329);浙江省医药卫生科技计划(编号2011KYB066);浙江省中医药卫生科技计划(编号2011ZB099);杭州市医疗卫生科研项目计划(编号20110833B05);浙江省医学会临床科研资金项目(编号2012ZYC-A35)

摘　　要：目的:提高对肾癌泌尿男性生殖道转移的认识。方法:总结我院20年来收治的2例患者资料,例1肾癌术后转移至同侧输尿管膀胱,例2肾透明细胞癌同时转移至同侧肾盂输尿管膀胱及前列腺,结合文献就其临床表现、转移机制、诊断及治疗进行讨论。结果:例1行残留输尿管及膀胱袖状切除术,例2行右肾癌根治性切除加膀胱全切回肠膀胱术,例1术后5年死于远处转移,例2术后2个月死于全身衰竭。结论:肾癌的泌尿男生殖道转移少见,转移机制尚不完全清楚,手术切除转移灶是首选推荐的治疗方法,肾癌根治术据病变情况可同时切除同侧全长输尿管并膀胱袖状切除。Objective： To improve the knowledge of renal cell carcinoma （RCC） with genitourinary tract metastasis. Method： Two cases from 1992 to 2002 were reviewed. RCC of one case metastasized to the ipsilateral ureter and bladder. The other case was found metastasis in the ipsilateral kidney pelvis, ureter, bladder and prostate. The clinical manifestations, metastatic mechanism, diagnosis and treatment were discussed oombined with literature review. Result： Resection of the affected remnant ureter on the ipsilateral side with bladder cuff resection was undertaken for the first case. Radical nephrectomy, total ureterectomy, radical cystectomy and ileal conduit were performed for the second case. The first case died of distant metastasis five years later and the second case died of systemic failure two months later. Conclusion： Male genitourinary tract metastasis from RCC is an extremely rare event. Thus, the metastatic mechanism of RCC is still controversial. Surgical resection of metastatic lesion is the first choice. Total ureterectomy and bladder cuff excision may be taken simultaneously with radical nephrectomy if necessary.

关 键 词：肾细胞癌 转移 输尿管 膀胱 前列腺 

分 类 号：R737.11[医药卫生—肿瘤]