An C, Okada Y, Hamaguchi A, Konishi T, Tomoyoshi T, Kataoka A
Department of Urology, Shiga University of Medical Science.
Hinyokika Kiyo. 1995 Feb;41(2):133-6.
A case of spontaneous rupture of the right kidney caused by a primary renal pelvic tumor is reported. A 57-year-old man complaining of right flank pain and gross hematuria was referred to our hospital in November 1992. In 1982, transurethral resection of the bladder tumor (TUR-Bt) and vesical instillation with mitomycin-C (MMC) had been performed at another hospital for recurrent bladder tumor. In 1988, the excretory urogram showed right hydronephrosis in the absence of a bladder tumor. In 1992, the excretory urogram revealed nonvisualization of the right kidney and obscurity of the right psoas muscle shadow. On the retrograde pyelogram, the upper calyx was irregular and the middle and lower calices were not clearly visualized. Selective renal arteriography demonstrated loss of continuity between the middle portion and lower poles. Right nephroureterectomy with bladder cuff was performed. The severely dilated pelvis contained a large amount of coagula and a papillary tumor. The thin renal parenchyme was lacerated at the lower pole. Histopathological findings revealed noninvasive transitional cell carcinoma. The present case represents the 6th spontaneous renal rupture caused by a renal pelvic tumor reported in Japan.
本文报告一例因原发性肾盂肿瘤导致右肾自发性破裂的病例。一名57岁男性,因右侧腰痛和肉眼血尿于1992年11月转诊至我院。1982年,患者曾因复发性膀胱肿瘤在另一家医院接受经尿道膀胱肿瘤切除术(TUR-Bt)及丝裂霉素C(MMC)膀胱灌注治疗。1988年,排泄性尿路造影显示右肾积水,无膀胱肿瘤。1992年,排泄性尿路造影显示右肾不显影,右侧腰大肌阴影模糊。逆行肾盂造影显示上肾盏不规则,中、下肾盏显影不清。选择性肾动脉造影显示肾中部与下极之间连续性中断。遂行右侧肾输尿管切除术并切除膀胱袖口组织。严重扩张的肾盂内有大量凝血块及一个乳头状肿瘤。肾实质变薄,下极有撕裂伤。组织病理学检查结果显示为非侵袭性移行细胞癌。该病例是日本报道的第6例因肾盂肿瘤导致的自发性肾破裂。