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脐尿管腺癌继发副肿瘤综合征所致急性肾小球肾炎:一种未知疾病。

Acute Glomerulonephritis as a Paraneoplastic Syndrome Secondary to Urachal Adenocarcinoma: An Unknown Entity.

作者信息

Bermúdez Barrientos Carmen G, Ramos Portales Marisol, Mendoza Villalobos Edna T, Moreno Jaime Brizio

机构信息

Medical Oncology, Institute for Social Security and Services for State Workers Regional Hospital, Leon, MEX.

General Surgery, Institute for Social Security and Services for State Workers Regional Hospital, Leon, MEX.

出版信息

Cureus. 2024 May 11;16(5):e60106. doi: 10.7759/cureus.60106. eCollection 2024 May.

Abstract

Urachal carcinoma is an uncommon malignancy with a peculiar biomolecular characterization and therefore a complex approach. It was incorporated by the World Health Organization in 2004 in the tumors of the urinary system classification. This neoplasm is generally diagnosed in advanced stages. The standard treatment is surgical, however, due to the rarity and relatively late clinical manifestation of urachal carcinomas, the survival data are mostly case reports, as well as information about medical-surgical treatment based on evidence. The data used were extracted from both the physical and electronic clinical records. Among atypical presentations reported in the literature, we report a case of urachal adenocarcinoma with simultaneous glomerulonephritis as a paraneoplastic syndrome of which there is no report to date. Surgery was carried out in our patient, unfortunately with lifetime morbidity from kidney function replacement secondary to kidney function damage by glomerulonephritis, despite previous immunosuppression treatment for rapidly progressive glomerulonephritis. It is worth mentioning that if the initial diagnosis represents a clinical challenge, treatment is even more complex, given the little information that currently exists about it. Urachal carcinoma is a diagnostic and treatment challenge. Up to now, surgery has been the treatment of choice in localized or locally advanced disease, however, with a high morbidity for the patient.

摘要

脐尿管癌是一种罕见的恶性肿瘤,具有独特的生物分子特征,因此治疗方法复杂。2004年,世界卫生组织将其纳入泌尿系统肿瘤分类。这种肿瘤通常在晚期才被诊断出来。标准治疗方法是手术,然而,由于脐尿管癌的罕见性和相对较晚的临床表现,生存数据大多是病例报告,以及基于证据的外科治疗信息。所使用的数据来自纸质和电子临床记录。在文献报道的非典型表现中,我们报告了一例脐尿管腺癌合并肾小球肾炎作为副肿瘤综合征的病例,迄今为止尚无此类报告。我们的患者接受了手术,不幸的是,尽管之前对快速进展性肾小球肾炎进行了免疫抑制治疗,但由于肾小球肾炎导致肾功能损害,患者终生需要进行肾功能替代治疗。值得一提的是,如果初始诊断是一项临床挑战,那么鉴于目前关于它的信息很少,治疗就更加复杂。脐尿管癌是诊断和治疗方面的挑战。到目前为止,手术一直是局部或局部晚期疾病的首选治疗方法,然而,这对患者来说发病率很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be75/11164558/5feb140fecc9/cureus-0016-00000060106-i01.jpg

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