Zhang Tao, Wang Qi, Min Jie, Yu Dexin, Xie Dongdong, Wang Yi, Ding Demao, Chen Lei, Zou Ci, Zhang Zhiqiang, Wang Daming
Department of Urology, The Second Hospital of Anhui Medical University, China.
Can Urol Assoc J. 2014 Nov;8(11-12):E859-61. doi: 10.5489/cuaj.2169.
Prostate cancer is one of the most common male malignancies, but it rarely metastasizes to the proximal ureter. We report a case of a 76-year-old man who presented with flank pain and lower urinary tract symptoms. Abdominal computed tomography scan revealed multiple filling defects at the middle of the left ureter, enlarged retroperitoneal lymph nodes, and probable psoas invasion. The patient underwent nephroureterectomy with excision of a cuff of bladder, and was found to have an adhesion between the middle part of left ureter and psoas intraoperatively. The pathological examination displayed positive immunohistochemical staining with prostate-specific antigen and prostate acid phostate, supporting the diagnosis of metastatic ureteral tumour from prostate cancer. In this case, periureteral soft tissue and ureteral muscular layer were infiltrated by metastatic tumour, whereas the mucosa was spared. The periureteral lymphatic pathway played an important role in the metastatic procedure of prostate cancer to the proximal ureter.
前列腺癌是最常见的男性恶性肿瘤之一，但它很少转移至近端输尿管。我们报告一例76岁男性患者，其表现为胁腹疼痛和下尿路症状。腹部计算机断层扫描显示左输尿管中段有多个充盈缺损、腹膜后淋巴结肿大以及可能的腰大肌侵犯。患者接受了肾输尿管切除术并切除了膀胱袖口组织，术中发现左输尿管中段与腰大肌之间存在粘连。病理检查显示前列腺特异性抗原和前列腺酸性磷酸酶免疫组化染色呈阳性，支持前列腺癌转移性输尿管肿瘤的诊断。在该病例中，转移性肿瘤浸润了输尿管周围软组织和输尿管肌层，而黏膜未受侵犯。输尿管周围淋巴途径在前列腺癌转移至近端输尿管的过程中起重要作用。
