Zhang Hao-Jie, Sheng Lu, Zhang Zhen-Wang, Sun Zhong-Quan, Qian Wei-Qing, Song Jian-da
Department of Urology, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai 200040, PR China.
Int J Surg Case Rep. 2012;3(1):37-8. doi: 10.1016/j.ijscr.2011.10.012. Epub 2011 Nov 3.
Metastasis of renal cell carcinoma to the contralateral ureter is extremely rare. To date, only 50 cases of metastatic RCC to the ureter have been reported, among whom 6 cases occur at the contralateral site. We herein report a rare case of metastatic RCC in the contralateral ureter 4 years after radical nephrectomy.
A 74-year-old man presented with gross, painless hematuria for one month. Computed tomography scan confirmed that a 1.5 cm × 0.5 cm tumor occurred in the contralateral distal ureter. A 3.5 cm segment of ureter was resected and a uretero-vesical anastomosis with psoas hitch was accomplished.
The reappearance of hematuria after radical nephrectomy is the most common manifestation of the metastasis to the bladder or ureter. The mechanism of metastasis is not clear. In pathology, vimentin and cytokeratins might help to differentiate between metastatic clear cell renal cell carcinoma and clear cell transitional cell carcinoma.
Metastasis of renal cell carcinoma to the contralateral ureter is rare. Early recognition is extremely important in protecting the remaining renal function and prolonging life-expectancy for post-nephrectomy patients. Complete metastectomy suitable anastomosis have been shown to improve survival.
肾细胞癌转移至对侧输尿管极为罕见。迄今为止，仅报道过50例输尿管转移性肾细胞癌病例，其中6例发生在对侧。我们在此报告1例根治性肾切除术后4年出现对侧输尿管转移性肾细胞癌的罕见病例。
一名74岁男性因肉眼无痛血尿1个月就诊。计算机断层扫描证实对侧输尿管远端有一个1.5厘米×0.5厘米的肿瘤。切除了3.5厘米长的输尿管段，并完成了带腰大肌悬吊的输尿管膀胱吻合术。
根治性肾切除术后血尿复发是转移至膀胱或输尿管最常见的表现。转移机制尚不清楚。在病理学上，波形蛋白和细胞角蛋白可能有助于区分转移性透明细胞肾细胞癌和透明细胞移行细胞癌。
肾细胞癌转移至对侧输尿管很罕见。早期识别对于保护肾切除术后患者的残余肾功能和延长预期寿命极为重要。已证明完整的转移灶切除术及合适的吻合术可提高生存率。
