Mertziotis Nikolaos, Kozyrakis Diomidis, Petrolekas Andreas, Terzi Maria, Kapranos Nikiforos
Department of Urology, Mitera Clinic, Hygeia group, Marousi, Attica;
Can Urol Assoc J. 2012 Dec;6(6):E274-6. doi: 10.5489/cuaj.11287.
A 62-year old male patient presented complaining of intermittent macroscopic hematuria. The ultrasonographic investigation revealed a hydronephrosis of remarkable degree with indiscrete renal parenchyma. The abdominal computed tomography scan identified a ureteral lesion with proximal dilatation, hydronephrosis and a functionless ipsilateral renal unit. The retrograde urography showed a 4-cm lesion with multiple filling defects and a smooth contour. The endoscopic examination showed an exophytic lesion, highly suspicious for malignancy. Urine cytology revealed atypia. Right nephroureterectomy was performed and the pathology revealed a ureteral inverted papilloma (UIP). Polymerase chain reaction examination for the presence of human papilloma virus, using GP5+/6+ consensus primers, was negative. The presence UIP should be considered in patients with urotheleal lesions in the ureter when the diagnostic workup for malignancy is inconclusive. The clinical course of the disease seems to be favorable.
一名62岁男性患者因间歇性肉眼血尿前来就诊。超声检查显示肾积水程度显著，肾实质不清晰。腹部计算机断层扫描发现输尿管病变伴近端扩张、肾积水以及同侧无功能肾单位。逆行尿路造影显示一个4厘米的病变，有多个充盈缺损且轮廓光滑。内镜检查显示一个外生性病变，高度怀疑为恶性肿瘤。尿液细胞学检查显示细胞异型性。行右侧肾输尿管切除术，病理结果显示为输尿管内翻性乳头状瘤（UIP）。使用GP5+/6+通用引物进行的人乳头瘤病毒聚合酶链反应检测为阴性。当对输尿管尿路上皮病变进行恶性肿瘤诊断检查结果不明确时，应考虑存在UIP。该病的临床病程似乎良好。
