Chen Zhuang-fei, Zheng Shao-bin, Wu Peng, Zhang Peng, Jiang Yao-dong, Zhao Shan-chao, Mao Xiang-ming, Chen Ze-rong, Shan Zheng-fei
Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 Dec;30(12):2765-7.
To study the clinicopathological characteristics of synchronous squamous cell carcinoma (SCC) of the renal pelvis and SCC of the ureter.
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 nephroureterectomy 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. Ureterolithotomy 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.
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.
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.
研究肾盂同步鳞状细胞癌(SCC)和输尿管SCC的临床病理特征。
回顾性分析2例肾盂同步SCC和输尿管SCC的临床资料。病例1,一名68岁男性,血尿1个月,影像学检查发现右肾盂肿瘤和右输尿管远端肿瘤。患者接受了肾输尿管切除术及膀胱袖口切除术。病例2,一名60岁男性,主诉下腹痛和左侧腰痛1个月,在另一家医院被诊断为左输尿管远端结石。行输尿管切开取石术,术中在结石下方发现输尿管肿瘤。病理报告显示为SCC,患者转入我院进一步治疗。我们在手术中发现左肾肿块侵犯左半结肠,遂行肾输尿管切除术及膀胱袖口切除术、左半结肠切除术,并进行了完整的淋巴结清扫。两名患者均未接受辅助放疗/化疗。
病例1的肾盂和输尿管均报告为中分化SCC,肿瘤侵犯肾盂的上皮下结缔组织和输尿管的浅肌层。病例2报告左肾盂中分化SCC伴结肠转移,输尿管低分化SCC伴两个腹膜后淋巴结转移。两名患者分别在术后5个月和6个月死于肿瘤复发和转移。
肾盂同步SCC和输尿管SCC罕见,早期复发和转移可能性高,预后通常较差。