Leonard A M, Lefevre A, Lagrange W
Department of Urology, Heilig Hartziekenhuis, Lier, Belgium.
Acta Urol Belg. 1996 Dec;64(4):23-5.
The occurrence of metastasis along the ureteral stump after previous radical nephrectomy for renal adenocarcinoma is very rare, only 47 cases having been reported in the literature. We present a case of metastasis of renal adenocarcinoma, occurring in the ureteral remnant, more than three years after ipsilateral radical nephrectomy. The analysis of this and previously reported cases leads us to propose radical nephro-ureterectomy as treatment of choice in certain cases of renal adenocarcinoma, instead of radical nephrectomy alone, notably when preoperative urine-cytology shows the presence of adenocarcinoma cells, and/or when vascular tumor infiltration is present. This adjuvant surgical step is of course only justified in those cases where a reasonable life-expectancy is present at the time of diagnosis, and thus especially applicable in the smaller T2 tumor group.
既往因肾腺癌行根治性肾切除术后输尿管残端发生转移极为罕见，文献中仅报道过47例。我们报告1例肾腺癌转移病例，发生于同侧根治性肾切除术后三年多的输尿管残端。对该病例及既往报道病例的分析使我们建议，在某些肾腺癌病例中，根治性肾输尿管切除术应作为首选治疗方法，而非仅行根治性肾切除术，特别是当术前尿细胞学检查显示存在腺癌细胞，和/或存在血管肿瘤浸润时。当然，这种辅助性手术步骤仅在诊断时预期生存期合理的病例中才合理，因此特别适用于较小的T2肿瘤组。
