Oake Justin, Drachenberg Darrel
Section of Urology, University of Manitoba, Winnipeg, MB, Canada.
Can Urol Assoc J. 2017 May;11(5):E233-E236. doi: 10.5489/cuaj.4290. Epub 2017 May 9.
Situs inversus, an uncommon mirror-image reversal of the major visceral and thoracic organs, is seldom of medical significance. However, the recognition of their unique anatomy is extremely important for those requiring surgical intervention. There are very few reported cases of renal cell carcinoma (RCC) developing in people with situs inversus. To our knowledge, this is the first reported case in Canada. A review of the literature only identified nine published cases worldwide. Here, we review and summarize pertinent information, including patient age and sex, size and location of tumour, method of surgery, and pathology. Our case, a 65-year-old male, presented with left flank pain and gross hematuria. He was diagnosed with left renal cancer as well as tumour thrombus extending into the left renal veins and inferior vena cava (IVC), clinical T3aN0M0. An abdomen and pelvis computed tomography (CT) scan showed a left-to-right reversal of his organs, a mirror-image, and situs inversus was diagnosed. A left radical nephrectomy with left renal vein and IVC tumour thrombectomy through a left open midline incision was performed.
内脏反位是一种主要内脏和胸部器官罕见的镜像反转，很少具有医学意义。然而，对于那些需要手术干预的人来说，认识到其独特的解剖结构极其重要。很少有关于内脏反位患者发生肾细胞癌（RCC）的报道病例。据我们所知，这是加拿大首例报道病例。文献回顾仅在全球范围内确定了9例已发表的病例。在此，我们回顾并总结相关信息，包括患者年龄和性别、肿瘤大小和位置、手术方法以及病理情况。我们的病例是一名65岁男性，表现为左侧腰痛和肉眼血尿。他被诊断为左肾癌以及肿瘤血栓延伸至左肾静脉和下腔静脉（IVC），临床分期为T3aN0M0。腹部和盆腔计算机断层扫描（CT）显示其器官左右反转，呈镜像，诊断为内脏反位。通过左正中切开进行了左根治性肾切除术及左肾静脉和下腔静脉肿瘤血栓切除术。
