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鹿角形结石合并肾积水患者第二例肾肿瘤的外科治疗:病例报告

Surgical treatment of kidney tumor on a patient with second case of staghorn calculus and associated renal hydronephrosis: case report.

作者信息

Alves Roger Arthur da Cunha, Barroso Francisco Marcos da Silva, de Andrade Gualter Ferreira, Façanha Neto César Dirceu, Brito Felipe Correa, Takeda Aline Naomi, da Costa Neto Ezequiel Fernandes, Costa Thayana Machado, Rodriguez Juan Eduardo Rios, Caminha Rafael Chateaubriend, Santana Monique Freire, Paiva Cristiano Silveira, de Sousa Flavio Antunes

机构信息

Urology Service, Getúlio Vargas University Hospital (HUGV), Manaus, Amazonas, Brazil.

General Surgery Service, Getúlio Vargas University Hospital (HUGV), Manaus, Amazonas, Brazil.

出版信息

AME Case Rep. 2019 Jun 11;3:19. doi: 10.21037/acr.2019.05.08. eCollection 2019.

Abstract

Staghorn, struvite or coral calculus are the ones that completely or partially occupies the renal pelvis and branches to the renal calices. The presence of renal calculi of any kind in the urinary tracts is related to the appearing of malign tumor in the kidneys, especially in the absence or failed treatment. A male patient, 51 years old, native of Manaus, reports about dysuria and polyuria associated with constant fever episodes and urinary tract infections with improvement by using several antibiotics but returning the symptoms after suspending it. The patient return was in a month and no improvement of the pain in the patient's feeling, with the tomography image tests result showing atrophy in the right kidney, which presents dilatation of the collector system, that it's filled with material with density varying between thick liquid and soft parts (average of 45 UH), in addition to calculus in the pelvis and ureteropelvic junction, suggesting a pattern for xanthogranulomatous pyelonephritis and matching previous history of right staghorn calculus. The association between kidney cancer and staghorn calculus should be consider through the treatment. Patients with renal diseases of severe prognosis in both kidneys must be kept under constant surveillance by the urology and nephrology team, the association of both clinics is essential to a fortunate ending like the case reported.

摘要

鹿角形、鸟粪石或珊瑚状结石是完全或部分占据肾盂并延伸至肾盏的结石。尿路中任何类型的肾结石的存在都与肾脏恶性肿瘤的出现有关,尤其是在未治疗或治疗失败的情况下。一名51岁的男性患者,来自马瑙斯,报告有排尿困难和多尿,伴有持续发热和尿路感染,使用多种抗生素后症状有所改善,但停药后症状复发。患者一个月后复诊,疼痛没有改善,断层扫描图像检查结果显示右肾萎缩,集合系统扩张,充满密度介于浓稠液体和软组织之间的物质(平均45 UH),此外肾盂和输尿管肾盂交界处有结石,提示为黄色肉芽肿性肾盂肾炎,与既往右鹿角形结石病史相符。在治疗过程中应考虑肾癌与鹿角形结石之间的关联。患有双侧严重预后肾病的患者必须由泌尿外科和肾病科团队持续监测,两个科室的联合对于像所报告病例这样的良好结局至关重要。

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