Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Tr- 34668, Istanbul, Turkey.
J Med Case Rep. 2021 Sep 26;15(1):475. doi: 10.1186/s13256-021-03070-3.
Fibroepithelial polyps located in the ureter constitute 2-6% of all benign tumors in the urinary system. Distinguishing these lesions from transitional cell carcinoma is essential to avoid unnecessary nephroureterectomy.
A 59-year-old asymptomatic caucasian male patient was enrolled in follow-up for Ta low-grade transitional cell bladder cancer 4 years ago in our clinic. A suspicious, solid, contrast-enhancing mass 15 × 9 mm in diameter in the anteromedial mid-section of the left kidney, which was causing minimal washout and largely located in the parenchyma, was reported as renal cell carcinoma on computed tomography during routine controls. In the excretory phase, soft-tissue densities of approximately 30 mm in length, which were located in the distal part of the left ureter at a distance of 40 mm from the ureterovesical junction, extending towards the lumen suggested a urethral carcinoma. Urothelial lesion was reported as fibroepithelial polyp after histopathological examination. Partial nephrectomy for the mass, which was reported as renal cell carcinoma in the left kidney, was performed in the first postoperative month. Histopathological examination revealed Fuhrman grade 1 papillary type renal cell carcinoma. No recurrence was observed in the first year after treatment.
Although our patient had a bladder transitional cell carcinoma and a suspicious renal cell carcinoma mass of 15 mm in the ipsilateral kidney, the patient was safeguarded from unnecessary nephroureterectomy early on by cross-sectional and endoscopic imaging of the ureter.
位于输尿管内的纤维上皮息肉占泌尿系统所有良性肿瘤的 2-6%。将这些病变与移行细胞癌区分开来对于避免不必要的肾输尿管切除术至关重要。
一位 59 岁无症状的白种男性患者四年前因 Ta 级低级别移行细胞膀胱癌在我们诊所接受随访。在常规检查中,计算机断层扫描报告左肾前内侧中段直径 15×9 毫米的可疑实性、增强的肿块,引起轻微洗脱,大部分位于实质内,被报告为肾细胞癌。在排泄期,左输尿管远端约 30 毫米长的软组织密度,距输尿管膀胱连接部 40 毫米处,向管腔延伸,提示为尿道癌。组织病理学检查报告为输尿管上皮病变为纤维上皮息肉。在左肾结石细胞癌报告为肾细胞癌的第一个术后月进行了部分肾切除术。组织病理学检查显示 Fuhrman 分级 1 型乳头状肾细胞癌。治疗后第一年未观察到复发。
尽管我们的患者有膀胱移行细胞癌和同侧肾脏 15 毫米的可疑肾细胞癌肿块,但通过输尿管的横断面和内镜成像,早期就为患者避免了不必要的肾输尿管切除术。