Morichetti Doriana, Mazzucchelli Roberta, Lopez-Beltran Antonio, Cheng Liang, Scarpelli Marina, Kirkali Ziya, Montorsi Francesco, Montironi Rodolfo
Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy.
BJU Int. 2009 Sep;104(6):770-6. doi: 10.1111/j.1464-410X.2009.08746.x. Epub 2009 Jul 14.
In this review we discuss those secondary tumours involving the urinary system and male genital organs that can pose differential diagnostic difficulties with primary lesions, and highlight morphological and ancillary features that could be helpful in reaching a proper assignment of primary origin.
Based on MEDLINE database searches all reports of secondary tumours involving the urinary system (kidney and bladder) and male genital organs (prostate, testis and penis) were examined.
Involvement by a secondary tumour occurs either as a metastasis or by direct extension. Among non-genitourinary primary sites, colorectal, pulmonary, skin (melanoma) and breast are the most common contributors. Secondary spread from a genitourinary site primary tumour to another genitourinary organ occurs most frequently between the prostate and urinary bladder, given the intimate topographic proximity of the two. The prognosis is very poor, as the secondary tumour usually occurs in patients with carcinoma in the late stages. Few secondary tumours have distinctive histological and immunohistochemical features, making it difficult to make the appropriate diagnosis. Hence, knowledge of the history and clinical setting are particularly important in these cases.
The urinary system and male genital organs are not common sites for secondary tumours. They often go either undiagnosed or misdiagnosed in the clinical follow-up of patients with cancer. Accurate diagnosis is essential because of differing therapeutic approaches compared with a primary neoplasm.
在本综述中，我们讨论那些累及泌尿系统和男性生殖器官的继发性肿瘤，这些肿瘤可能在与原发性病变的鉴别诊断中造成困难，并强调有助于正确判断原发部位的形态学和辅助特征。
基于对MEDLINE数据库的检索，对所有累及泌尿系统（肾脏和膀胱）和男性生殖器官（前列腺、睾丸和阴茎）的继发性肿瘤报告进行了检查。
继发性肿瘤的累及可通过转移或直接蔓延发生。在非泌尿生殖系统原发部位中，结直肠、肺、皮肤（黑色素瘤）和乳腺是最常见的来源。由于前列腺和膀胱在解剖位置上紧邻，泌尿生殖系统原发肿瘤从一个部位向另一个泌尿生殖器官的继发性扩散最常发生在前列腺和膀胱之间。预后非常差，因为继发性肿瘤通常发生在癌症晚期的患者中。很少有继发性肿瘤具有独特的组织学和免疫组化特征，这使得做出正确诊断很困难。因此，在这些病例中，了解病史和临床情况尤为重要。
泌尿系统和男性生殖器官不是继发性肿瘤的常见部位。在癌症患者的临床随访中，它们常常未被诊断或误诊。由于与原发性肿瘤的治疗方法不同，准确诊断至关重要。
