Mustafa Mahmoud, Hijaz Hatem, Aghbar Amir, Barqawi Abdelkarim, Alami Ibraheem, Khalil Nabil
Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Department of Urology, An-Najah National University Hospital, Nablus, Palestine.
SAGE Open Med Case Rep. 2024 Sep 30;12:2050313X241288341. doi: 10.1177/2050313X241288341. eCollection 2024.
Upper tract transitional cell carcinoma poses diagnostic challenges due to its prevalence and diverse clinical presentations. This case report describes the incidental discovery of high-grade transitional cell carcinoma during the management of a 48-year-old male with ischemic heart disease and an asymptomatic right renal stone. During flexible ureteroscopy for stone removal, papillary lesions were identified within a calyceal diverticulum and confirmed as high-grade transitional cell carcinoma. The unique anatomy of the calyceal diverticulum, characterized by its restricted wall thickness, may predispose the tumor to early metastasis. Additionally, there is a concern about potential iatrogenic dissemination of tumor cells to the bladder during the ureteroscopic procedure. This case highlights the diagnostic complexities associated with upper tract transitional cell carcinoma in rare anatomical locations and emphasizes the need for careful consideration of both procedural factors and anatomical features to manage the risk of metastasis and tumor dissemination effectively.
上尿路移行细胞癌因其发病率和多样的临床表现而带来诊断挑战。本病例报告描述了在一名患有缺血性心脏病且右肾有无症状结石的48岁男性的治疗过程中偶然发现高级别移行细胞癌的情况。在进行输尿管软镜取石术时，在肾盏憩室内发现乳头状病变，并确诊为高级别移行细胞癌。肾盏憩室独特的解剖结构，其特点是壁厚受限，可能使肿瘤易于早期转移。此外，人们担心在输尿管镜检查过程中肿瘤细胞可能会发生医源性播散至膀胱。本病例突出了罕见解剖部位上尿路移行细胞癌相关的诊断复杂性，并强调需要仔细考虑手术因素和解剖特征，以有效管理转移和肿瘤播散的风险。
