Department of Neuro-Urology, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, Hamburg, Germany.
Urological Practice, Sankt Augustin, Germany.
Spinal Cord Ser Cases. 2021 Nov 29;7(1):102. doi: 10.1038/s41394-021-00466-7.
For individuals with spinal cord injury/disease (SCI/D) the risk of developing a stone in the upper urinary tract is up to six times higher than in the able-bodied population. Upper urinary tract carcinomas, in general, are rare and account for only 5-10% of all urinary tract carcinomas. It is believed that chronic upper urinary tract irritation caused by e.g., kidney stones or recurrent upper urinary tract infections may be associated with an increased risk of renal squamous cell carcinoma (RSCC).
We report on a 64-year-old male who suffered a spinal cord injury in 1981 resulting in a complete sensory and motor impairment below T6, AIS A. Recurrent left-sided kidney stone disease had to be treated repeatedly from 1984 onwards. Despite repeated surgical attempts, it was ultimately not possible to achieve stone clearance in the long term. Within the concept of life-long surveillance of SCI/D, the patient was examined regularly, including ultrasound examinations of the kidneys. Six months after the last control examination, the patient was admitted to our hospital with a locally advanced tumor of the left kidney, so that only the option of palliative treatment remained. Histologically an RSCC was found.
As people with SCI/D have a higher risk of developing kidney stones, it is of utmost importance to check regularly for stone disease and, if necessary, treat with the aim of long-term stone clearance in order to protect renal function and to avert potentially malignant changes at an early stage.
对于脊髓损伤/疾病(SCI/D)患者,上尿路结石的风险比健康人群高 6 倍。上尿路癌一般较为罕见,仅占所有尿路癌的 5-10%。人们认为,肾结石或反复上尿路感染等引起的慢性上尿路刺激可能与肾鳞癌(RSCC)风险增加有关。
我们报告了一名 64 岁男性,1981 年因脊髓损伤导致 T6 以下完全感觉和运动功能障碍,AIS A。1984 年以来,左侧肾结石疾病反复发作,需反复治疗。尽管多次手术尝试,最终仍无法长期清除结石。根据 SCI/D 终身监测的概念,该患者定期接受检查,包括肾脏超声检查。最后一次检查后 6 个月,患者因左肾局部晚期肿瘤入院,仅能进行姑息治疗。组织学检查发现为 RSCC。
由于 SCI/D 患者发生肾结石的风险较高,因此定期检查结石疾病并在必要时进行治疗以达到长期清除结石的目的至关重要,以保护肾功能并尽早发现潜在的恶性变化。