Gao Xinghua, Xing Qingfei, Luo Xudong, Cao Tingshuai, Zhang Shimin, Yang Fei, Fan Daming, Gao Zhen, Zhang Longyang, Guo Feng
Department of Urology.
Department of Medical Imaging.
Medicine (Baltimore). 2020 Sep 18;99(38):e22329. doi: 10.1097/MD.0000000000022329.
A supernumerary kidney is an extremely rare renal anomaly. Currently, <100 cases are reported in the literature. There are only 2 right unilateral supernumerary kidneys reported in the literature thus far, but no confirmed cases of urothelial carcinoma in supernumerary kidneys. We report a case of a right supernumerary with urothelial carcinoma, which is, to the best of our knowledge, reported for the first time.
A 73-year-old female patient presented with intermittent, painless, whole course and gross hematuria for about 3 months. Her physical and laboratory examinations did not reveal any significant findings except positive occult blood in routine urine examination. Contrast-enhanced spiral computed tomography revealed a dysplastic supernumerary kidney under the normal right kidney.
The ureteroscopy showed that the ureter was Y-shaped in the middle part. The medial ureter led to a normal kidney. The lateral ureter was just 2 cm and led to a small cavity in which there was a mass whose biopsy showed urothelial carcinoma. The patient was subsequently diagnosed with a right supernumerary kidney with urothelial carcinoma.
Nephroureterectomy, including the right normal and supernumerary kidneys, and partial cystectomy by laparoscopy were performed after the ureteroscopy. The patient then received 6 cycles of gemcitabine and cisplatin regimen chemotherapy and regular intravesical epirubicin chemotherapy.
No recurrence or metastasis was found on follow-up computed tomography performed 13 months postoperatively.
A supernumerary kidney is an extremely rare renal anomaly. Malignancy can occur in supernumerary kidneys.
额外肾是一种极其罕见的肾脏异常。目前,文献报道的病例<100例。迄今为止,文献中仅报道了2例右侧单侧额外肾,但尚无额外肾发生尿路上皮癌的确诊病例。我们报告了1例右侧额外肾合并尿路上皮癌的病例,据我们所知,这是首次报道。
一名73岁女性患者出现间歇性、无痛性全程肉眼血尿约3个月。除尿常规潜血阳性外,其体格检查和实验室检查未发现任何明显异常。增强螺旋计算机断层扫描显示右肾正常位置下方有一个发育异常的额外肾。
输尿管镜检查显示输尿管中段呈Y形。内侧输尿管通向正常肾脏。外侧输尿管仅2厘米,通向一个小腔,腔内有一个肿块,活检显示为尿路上皮癌。该患者随后被诊断为右侧额外肾合并尿路上皮癌。
输尿管镜检查后,通过腹腔镜进行了肾输尿管切除术,包括右侧正常肾和额外肾,以及部分膀胱切除术。患者随后接受了6个周期的吉西他滨和顺铂方案化疗以及定期膀胱内表柔比星化疗。
术后13个月的随访计算机断层扫描未发现复发或转移。
额外肾是一种极其罕见的肾脏异常。额外肾可发生恶性肿瘤。