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一名异位肾伴慢性肾盂肾炎患者发生肾盂肾盏鳞状细胞癌:病例报告

Renal pyelocalyceal squamous cell carcinoma in a patient with an ectopic kidney presenting with chronic pyelonephritis: a case report.

作者信息

Güler Yavuz, Üçpınar Burak, Erbin Akif

机构信息

Department of Urology, Private Safa Hospital, Istanbul, Turkey.

Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey.

出版信息

J Med Case Rep. 2019 May 23;13(1):154. doi: 10.1186/s13256-019-2090-z.

Abstract

BACKGROUND

Until now, few cases of pelvis squamous cell carcinoma in various renal anomalies have been reported. To our knowledge, primary squamous cell carcinoma arising from a pelvic ectopic kidney has never been described. In this report, we describe a case of renal pyelocalyceal squamous cell carcinoma in a patient with an ectopic kidney presenting with chronic pyelonephritis. A 73-year-old Caucasian woman presented to our hospital with pyelonephritis symptoms. Abdominopelvic computed tomography revealed heterogeneous and irregular minimal contrast enhancement in the pelvic ectopic kidney parenchyma. Radiologists reported that the images were consistent with chronic pyelonephritis. A Tc-99m dimercaptosuccinic acid renal scan demonstrated a nonfunctioning right pelvic ectopic kidney. The patient underwent open simple nephrectomy via modified Gibson incision. The whole mass was a distended, saclike structure without any grossly visible renal tissue. Pathological examination showed renal pelvis squamous cell carcinoma 8 cm in diameter infiltrating into the renal capsule and perinephritic fatty tissue. The patient was staged as T4N0M1 renal pelvis squamous cell carcinoma. The patient was being treated in the intensive care unit for respiratory distress on the seventh day after the operation. By the first-month follow-up visit, the patient had died of acute respiratory distress syndrome.

CONCLUSIONS

Although rare, renal pelvis squamous cell carcinoma should be considered in the differential diagnosis of a renal mass in patients who have renal anomalies and chronic pyelonephritis.

摘要

背景

迄今为止,各种肾异常中盆腔鳞状细胞癌的病例报道较少。据我们所知,盆腔异位肾原发性鳞状细胞癌从未被描述过。在本报告中,我们描述了一例患有慢性肾盂肾炎的异位肾患者发生肾盂肾盏鳞状细胞癌的病例。一名73岁的白人女性因肾盂肾炎症状前来我院就诊。腹盆腔计算机断层扫描显示盆腔异位肾实质内不均匀且不规则的轻微对比增强。放射科医生报告称,图像与慢性肾盂肾炎相符。锝-99m二巯基丁二酸肾扫描显示右侧盆腔异位肾无功能。患者通过改良吉布森切口接受了开放性单纯肾切除术。整个肿块是一个扩张的囊状结构,没有任何肉眼可见的肾组织。病理检查显示直径8厘米的肾盂鳞状细胞癌浸润至肾包膜和肾周脂肪组织。该患者被分期为T4N0M1期肾盂鳞状细胞癌。术后第七天,患者因呼吸窘迫在重症监护病房接受治疗。在第一个月的随访中,患者死于急性呼吸窘迫综合征。

结论

虽然罕见,但在患有肾异常和慢性肾盂肾炎的患者中,肾盂鳞状细胞癌应在肾肿块的鉴别诊断中予以考虑。

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