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儿童纤维上皮息肉:上尿路梗阻的一种罕见病理情况

Fibroepithelial Polyp in a Child: A Rare Pathology of Upper Urinary Tract Obstruction.

作者信息

Alhindi Saeed, Alaradi Husain, Mubarak Mohamed

机构信息

Pediatric Surgery, Salmaniya Medical Complex, Manama, BHR.

Surgery, Salmaniya Medical Complex, Manama, BHR.

出版信息

Cureus. 2020 Jun 21;12(6):e8748. doi: 10.7759/cureus.8748.

Abstract

Fibroepithelial polyp is a rare benign tumor of the urothelial system that originates from the mesoderm. Polyps are usually small and located in the upper urinary tract and ureteropelvic junction. However, in the pediatric population, such polyps are more common in the posterior urethra and will present with symptoms of urinary tract obstruction. Some will present with flank pain and hematuria, resembling symptoms of ureteric stones. In this case, we discuss a nine-year-old boy presenting with complaints of flank pain and hematuria for one year. Following laboratory and radiological investigations, the left ureter was dilated at the mid-lumbar region with an anteroposterior diameter of 2.3 x 0.6 cm and a left renal pelvis anteroposterior diameter of 2.2 cm. An ultrasound scan identified an intraluminal lesion suspected to be a fibroepithelial polyp. Management was carried out via retroperitoneal surgery with upper ureteral resection and end-to-end anastomosis. Postoperatively, the patient's symptoms improved, and a subsequent ultrasound scan and renal function test showed improvement of the left hydroureter and hydronephrosis.

摘要

纤维上皮性息肉是一种罕见的起源于中胚层的尿路上皮系统良性肿瘤。息肉通常较小,位于上尿路和输尿管肾盂连接处。然而,在儿童群体中,此类息肉在后尿道更为常见,并会出现尿路梗阻症状。有些会表现为胁腹疼痛和血尿,类似输尿管结石的症状。在此病例中,我们讨论一名9岁男孩,他主诉胁腹疼痛和血尿1年。经过实验室和影像学检查,左输尿管在腰中部区域扩张,前后径为2.3×0.6厘米,左肾盂前后径为2.2厘米。超声扫描发现腔内病变,怀疑为纤维上皮性息肉。通过腹膜后手术进行上输尿管切除并端端吻合。术后,患者症状改善,随后的超声扫描和肾功能检查显示左输尿管积水和肾积水有所改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dac/7377021/6326b6caf228/cureus-0012-00000008748-i01.jpg

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