García Ligero Julián, Navas Pastor Jacinto, García García Felipe, Sempere Gutiérrez Andrés, Rico Galiano José Luis, Tomás Ros Mariano, Fontana Compiano Luis Oscar
Servicio de Urología, Hospital General Universitario, Murcia, España.
Arch Esp Urol. 2002 May;55(4):443-6.
To present a case of urothelial tumor inside a simple ureterocele with a coexisting contralateral tumor that caused bilateral obstructive uropathy.
Follow-up evaluation of a 74-year-old male patient with superficial tumor of the urinary bladder diagnosed 4 years earlier, revealed renal failure and bilateral obstructive uropathy. The complementary tests showed a simple left ureterocele containing a lesion suggestive of a tumor and a right ureteral tumor.
After biopsy confirmed coexisting urothelial disease at 3 levels (intraureterocele, contralateral ureter and in situ carcinoma of the bladder), the patient was submitted to cystoprostatectomy, nephroureterectomy and en bloc segmental ureterectomy.
Multicentric synchronous urothelial tumors warrant a close and long follow-up of the entire urinary tract. Among the possible sites of presentation, few cases of tumors inside a ureterocele have been reported. The case described herein, with this uncommon site of presentation, is an example of panurothelial disease.
报告一例单纯输尿管囊肿内发生尿路上皮肿瘤并伴有对侧肿瘤,导致双侧梗阻性尿路病的病例。
对一名74岁男性患者进行随访评估,该患者4年前被诊断为膀胱浅表肿瘤,此次评估发现肾衰竭和双侧梗阻性尿路病。辅助检查显示左侧单纯输尿管囊肿内有一个提示肿瘤的病变,右侧输尿管有肿瘤。
活检证实存在3个层面的并存尿路上皮病变(输尿管囊肿内、对侧输尿管和膀胱原位癌)后,该患者接受了膀胱前列腺切除术、肾输尿管切除术和整块节段性输尿管切除术。
多中心同步尿路上皮肿瘤需要对整个尿路进行密切且长期的随访。在可能出现肿瘤的部位中,输尿管囊肿内发生肿瘤的病例报道较少。本文所述病例具有这种不常见的肿瘤发生部位,是全尿路上皮疾病的一个实例。