Wu Tielin, Haleem Harris, Yin Min
Department of Urology, Ningbo Medical Treatment Centre Li Huili Hospital, Ningbo, China.
Front Oncol. 2022 Jul 28;12:889028. doi: 10.3389/fonc.2022.889028. eCollection 2022.
Recurrence of urothelial carcinoma in a patient with solitary kidney is always a clinical challenge. In the immune checkpoint inhibitor era, neoadjuvant immunotherapy in combination with the Yang-Monti technique might be a good option for the patient with a high-risk tumor when kidney-sparing surgery for renal function preservation is desired. We report the case of a 74-year-old man with solitary kidney who was diagnosed with recurrence of urothelial carcinoma in the right ureter. He was initially deemed unfit for segmental resection of the ureter. Neoadjuvant immunotherapy with tislelizumab was performed in this patient with a partial response to urothelial carcinoma. He underwent segmental resection of the ureter with negative margins, and the ureteral defect was bridged by modified ileal replacement, which is the Yang-Monti technique. This patient has remained disease-free with adequate kidney function for longer than 18 months.
孤立肾患者发生尿路上皮癌复发始终是一项临床挑战。在免疫检查点抑制剂时代,对于期望保留肾功能而行保肾手术的高危肿瘤患者,新辅助免疫治疗联合杨-蒙蒂技术可能是一个不错的选择。我们报告一例74岁孤立肾男性患者,其被诊断为右侧输尿管尿路上皮癌复发。他最初被认为不适合行输尿管节段性切除术。该患者接受了替雷利珠单抗新辅助免疫治疗,对尿路上皮癌有部分反应。他接受了切缘阴性的输尿管节段性切除术,输尿管缺损采用改良回肠替代术(即杨-蒙蒂技术)进行修复。该患者已无病生存且肾功能良好超过18个月。