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肾盂绒毛状腺瘤的早期诊断:一例报告

Early diagnosis of renal pelvis villous adenoma: A case report.

作者信息

Li Liang-Liang, Song Pei-Xing, Xing De-Fu, Liu Kun

机构信息

Department of Urology, Fuyang Hospital of Anhui Medical University, Fuyang 236000, Anhui Province, China.

出版信息

World J Clin Cases. 2023 Sep 16;11(26):6159-6164. doi: 10.12998/wjcc.v11.i26.6159.

Abstract

BACKGROUND

Villous adenoma is a rare tumor in the urinary system that usually occurs in the bladder. It is extremely uncommon in the renal pelvis. Most of the previously reported cases have been diagnosed with severe hydronephrosis associated with renal parenchyma atrophy prior to surgery. Because of its rarity, available information on the pathogenesis, diagnosis, treatment and prognosis of the disease is limited. We reported a case of kidney stones with hydronephrosis. During percutaneous nephroscopic lithotripsy, a renal pelvis tumor was found. Biopsy confirmed that the tumor was a villous adenoma of the renal pelvis.

CASE SUMMARY

A 68-year-old female was admitted to the hospital due to right kidney stones with right hydronephrosis. After admission, a urinary system plain computed tomography scan was performed, which revealed right kidney stones with right hydronephrosis and right upper ureteral dilatation. Multiple new cauliflower-like papillary masses were then discovered in the renal pelvis and calyces during right percutaneous nephroscopic lithotripsy. Biopsy results indicated villous adenoma with high-grade glandular intraepithelial neoplasia. The patient underwent laparoscopic radical resection of the right kidney and ureter. Based on histopathological and immunohistochemical examination, the patient was diagnosed with villous adenoma without adenocarcinoma.

CONCLUSION

Villous adenoma is rare in the urinary system. We reported a case of renal pelvis villous adenoma, which may provide useful information for the early diagnosis and treatment of this tumor.

摘要

背景

绒毛状腺瘤是泌尿系统中一种罕见的肿瘤,通常发生于膀胱。在肾盂中极为罕见。先前报道的大多数病例在手术前已被诊断为伴有肾实质萎缩的严重肾积水。由于其罕见性,关于该疾病的发病机制、诊断、治疗和预后的可用信息有限。我们报告了一例伴有肾积水的肾结石病例。在经皮肾镜碎石术中,发现了一个肾盂肿瘤。活检证实该肿瘤为肾盂绒毛状腺瘤。

病例摘要

一名68岁女性因右肾结石伴右肾积水入院。入院后,进行了泌尿系统平扫计算机断层扫描,结果显示右肾结石伴右肾积水及右上段输尿管扩张。在右侧经皮肾镜碎石术中,随后在肾盂和肾盏中发现了多个新的菜花状乳头状肿物。活检结果显示为伴有高级别腺上皮内瘤变的绒毛状腺瘤。患者接受了腹腔镜下右肾及输尿管根治性切除术。基于组织病理学和免疫组化检查,该患者被诊断为无腺癌的绒毛状腺瘤。

结论

绒毛状腺瘤在泌尿系统中罕见。我们报告了一例肾盂绒毛状腺瘤病例,这可能为该肿瘤的早期诊断和治疗提供有用信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a69c/10507558/8d64b63de7fc/WJCC-11-6159-g001.jpg

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本文引用的文献

3
Villous Adenoma of the Urinary Bladder: A Brief Review of the Literature.膀胱绒毛状腺瘤:文献综述
Arch Pathol Lab Med. 2016 Jan;140(1):91-3. doi: 10.5858/arpa.2014-0198-RS.
6
Intestinal type villous adenoma of the renal pelvis.肾盂肠型绒毛状腺瘤
Can Urol Assoc J. 2013 Jan-Feb;7(1-2):E138-42. doi: 10.5489/cuaj.257.
9
Villous adenoma of the renal pelvis and ureter.肾盂和输尿管绒毛状腺瘤
Indian J Urol. 2010 Oct;26(4):598-9. doi: 10.4103/0970-1591.74478.
10
Villous adenoma of the ureter with manifestation of mucus hydroureteronephrosis.
J Chin Med Assoc. 2007 Jan;70(1):33-5. doi: 10.1016/S1726-4901(09)70298-9.

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