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以尿路梗阻为首发表现的前列腺侵袭性血管黏液瘤:1例罕见病例报告及文献复习

Prostatic aggressive angiomyxoma (AAM) with initial presentation of urinary obstruction: a rare case report and literature review.

作者信息

Lai Chin-Hui, Ji Jiaxiang, Bian Xiaolong, Xu Tao, Hu Hao

机构信息

Department of Urology, Peking University People's Hospital, Beijing, China.

The Institute of Applied Lithotripsy Technology, Peking University, Beijing, China.

出版信息

Transl Androl Urol. 2024 Dec 31;13(12):2827-2832. doi: 10.21037/tau-24-425. Epub 2024 Dec 28.

Abstract

BACKGROUND

Aggressive angiomyxoma (AAM) is a rare benign mesenchymal tumor known for its aggressive behavior and high recurrence rates, with male cases of AAM being less frequently reported. This study presents a rare case of primary prostatic AAM characterized by a prostatic urethral mass obstructing the bladder outlet, resulting in acute renal dysfunction.

CASE DESCRIPTION

The 51-year-old male patient presented with lumbar pain, nausea, frequent urination, urgency, and incomplete urination. Laboratory test indicated increased levels of serum creatinine and potassium. Emergency bedside ultrasound found giant bilateral hydronephrosis. The patient received emergent potassium-lowering therapy and bilateral nephrostomy. Computed tomography (CT) revealed a 3.7 cm × 2.3 cm low-density soft tissue mass in prostate. Transurethral resection of the prostatic mass was performed. Pathological examination identified the presence of deep-seated AAM. For fear of recurrence, he underwent radical prostatectomy. Postoperative histopathology showed no sign of residual tumor. He recovered uneventfully and is now under regular follow-up.

CONCLUSIONS

AAM is a rarely reported locally aggressive mesenchymal neoplasm characterized by high recurrence, which was even rarer in prostate. As we know, this is the first case of prostatic AAM treated by both transurethral resection and further radical resection. In this case, the tumor was completely excised surgically, but long-term follow-up is required to monitor for recurrence.

摘要

背景

侵袭性血管黏液瘤(AAM)是一种罕见的良性间叶性肿瘤,以其侵袭性行为和高复发率而闻名,男性AAM病例报道较少。本研究报告了一例罕见的原发性前列腺AAM,其特征为前列腺尿道肿块阻塞膀胱出口,导致急性肾功能不全。

病例描述

一名51岁男性患者出现腰痛、恶心、尿频、尿急和排尿不全。实验室检查显示血清肌酐和钾水平升高。急诊床边超声发现双侧巨大肾积水。患者接受了紧急降钾治疗和双侧肾造瘘术。计算机断层扫描(CT)显示前列腺有一个3.7 cm×2.3 cm的低密度软组织肿块。行经尿道前列腺肿块切除术。病理检查确诊为深部AAM。因担心复发,患者接受了前列腺根治术。术后组织病理学检查未发现残留肿瘤迹象。患者恢复顺利,目前正在定期随访中。

结论

AAM是一种报道较少的具有局部侵袭性的间叶性肿瘤,其特点是高复发率,在前列腺中更为罕见。据我们所知,这是首例行经尿道切除术及进一步根治性切除术治疗的前列腺AAM。在本病例中,肿瘤通过手术完全切除,但需要长期随访以监测复发情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9fc/11732294/3a856f8e740b/tau-13-12-2827-f1.jpg

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