Sugimoto Hitoshi, Oda Goshi, Yokoyama Minato, Hayashi Kumiko, Yoshino Maho, Ogawa Ayumi, Hosoya Tokuko, Nakagawa Tsuyoshi, Uetake Hiroyuki
Department of Specialized Surgery, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
Department of Urology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
Case Rep Oncol. 2021 Mar 9;14(1):378-385. doi: 10.1159/000513903. eCollection 2021 Jan-Apr.
Breast cancer metastasizes mainly to organs such as bone, lung, and liver, whereas metastases to the peritoneum and urinary tract are rare. Metastasis to the peritoneum or urinary tract may result in renal dysfunction, infection, and painful hydronephrosis. In our hospital, 1,409 breast cancer surgeries were performed between January 2004 and December 2015, and 7 cases of hydronephrosis associated with recurrence were observed. The median age of patients was 69 years (57-79 years). The median time from surgery to diagnosis of hydronephrosis was 47 months (20-70 months). Histology was invasive ductal carcinoma (IDC) in 6 cases and invasive lobular carcinoma (ILC) in 1 case. There were 6 bilateral cases and 1 unilateral case of hydronephrosis. The causes were retroperitoneal metastasis in 5 cases and lymph node metastasis in 2 cases. The hydronephrosis was untreated in 2 cases, and treated with a ureteral stent in 2 cases, nephrostomy in 1 case, and nephrostomy due to ureteral stent failure in 2 cases. The median survival from the onset of hydronephrosis was 12 months (3-57 months). Although the probability of hydronephrosis in breast cancer recurrence was not high, care must be taken to avoid renal dysfunction, infection, or pain, which may require treatment.
乳腺癌主要转移至骨、肺和肝等器官,而转移至腹膜和泌尿道的情况较为罕见。转移至腹膜或泌尿道可能导致肾功能障碍、感染和疼痛性肾积水。在我院,2004年1月至2015年12月期间共进行了1409例乳腺癌手术,观察到7例与复发相关的肾积水病例。患者的中位年龄为69岁(57 - 79岁)。从手术到诊断为肾积水的中位时间为47个月(20 - 70个月)。组织学类型为浸润性导管癌(IDC)6例,浸润性小叶癌(ILC)1例。肾积水病例中有6例为双侧,1例为单侧。病因是腹膜后转移5例,淋巴结转移2例。2例肾积水未治疗,2例采用输尿管支架治疗,1例采用肾造瘘术,2例因输尿管支架失败而行肾造瘘术。肾积水发病后的中位生存期为12个月(3 - 57个月)。虽然乳腺癌复发时发生肾积水的概率不高,但必须注意避免可能需要治疗的肾功能障碍、感染或疼痛。