Galifer R B, Aubert D, Couture A, Veyrac C, Barneon C, Kötter R
Service de Chirurgie Infantile, CHU Saint-Charles, Montpellier.
Chir Pediatr. 1988;29(6):318-24.
Primary ureteral tumors are rare and benign ones constitute only a small portion. Of the benign neoplasms, fibro epithelial polyps are probably the most common and could be considered to be an exceedingly rare cause of Hydronephrosis in children. The exact etiology of benign ureteral polyps is not certain but it is likely that they have a congenital one. They are mesodermal in origin and consist of a thick fibrous stalk covered by a layer of normal transitional epithelium. They are more commonly found in boys (80.6%), who present usually with abdominal pains or renal colics. Fibro-epithelial polyps often rise in the proximal ureter and renal pelvis, especially at the left side (69.4%). Radiographic signs are those of a non typical uretero-pelvic Junction obstruction. IVP and retrograde ureterogram usually demonstrate a long, thin, filiform, lucent filling defect within the ureteral lumen with moderate hydronephrosis. Appropriate treatment of these benign tumors is local excision with or without segmental resection. Prognosis should be considered as excellent without a report of recurrence. A review of the literature revealed 33 cases of ureteral polyps in children. We report here 3 additional cases of obstructing fibro epithelial polyps, observed in boys aged respectively 4, 8 and 9 years.
原发性输尿管肿瘤较为罕见，其中良性肿瘤仅占一小部分。在良性肿瘤中，纤维上皮息肉可能最为常见，可被视为儿童肾积水极为罕见的病因。良性输尿管息肉的确切病因尚不确定，但很可能具有先天性。它们起源于中胚层，由一层正常移行上皮覆盖的粗大纤维蒂组成。它们更常见于男孩（80.6%），通常表现为腹痛或肾绞痛。纤维上皮息肉常起源于输尿管近端和肾盂，尤其是左侧（69.4%）。影像学表现为非典型输尿管肾盂连接处梗阻。静脉肾盂造影（IVP）和逆行输尿管造影通常显示输尿管腔内有长而细的丝状透亮充盈缺损，并伴有中度肾积水。这些良性肿瘤的适当治疗方法是局部切除，可伴或不伴节段性切除。预后应被视为良好，尚无复发报告。文献回顾显示有33例儿童输尿管息肉病例。我们在此报告另外3例梗阻性纤维上皮息肉病例，分别见于4岁、8岁和9岁的男孩。
