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因存在鳞状细胞癌而使感染性鹿角状结石的肾切除术变得复杂。

Nephrectomy for infected stag horn calculus confounded by the presence of squamous cell carcinoma.

作者信息

Kondisetty Sandeep, Borkar Pallavi Vijay, Thomas Appu

机构信息

Department of Urology, Amrita Institute of Medical Sciences and Research Centre, Kochi, India.

Department of Pathology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.

出版信息

BMJ Case Rep. 2017 Sep 27;2017:bcr-2017-220230. doi: 10.1136/bcr-2017-220230.

Abstract

Squamous cell carcinoma of kidney is a rare tumour of the many tumours seen in the kidney. It is usually associated with chronic irritation by a foreign body, which is mostly a stag horn calculus. Diagnosis of carcinoma in the presence of stag horn calculus is bizarre as it is seen in only <1% of patients. After imaging in this patient, the lymph nodes were enlarged and showed necrosis, which favoured the diagnosis of tuberculosis in a country where it is endemic. The pathological examination after surgery has amazed us by the presence of squamous cell carcinoma with lymph nodes positive with metastasis to vertebrae as the patient has presented to us with all symptoms of infection like pain and fever, which never made us think about malignancy preoperatively.

摘要

肾鳞状细胞癌是肾脏众多肿瘤中一种罕见的肿瘤。它通常与异物的慢性刺激有关,异物大多是鹿角形结石。在鹿角形结石存在的情况下诊断癌症很奇怪,因为仅在不到1%的患者中可见。对该患者进行影像学检查后,淋巴结肿大并显示坏死,在该病流行的国家,这支持了结核病的诊断。手术后的病理检查令我们惊讶,发现存在鳞状细胞癌,淋巴结转移至椎骨呈阳性,因为该患者向我们表现出所有感染症状,如疼痛和发热,术前我们从未想到是恶性肿瘤。

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