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肾癌输尿管转移非常罕见,国外共报道52例。1988年～1998年作者共收治3例,现报告如下: 例1.患者女,41岁。左肾癌术后2年,左腰部无痛性肿物伴间断性肉眼血尿2月于1990年12月入院。查体:左输尿管走行区可触及一约7.0cm×6.0cm肿物,质地硬,表面尚光滑,活动度差,无触痛。尿常规红细胞满视野,B超报告左腹部实性肿物。膀胱镜检查见左输尿管开口喷血,左输尿管逆行造影显示左输尿管残端不规则充盈缺损。临床诊断为左输尿管残端癌。术中见左结肠内侧有一大小约8.0cm×7.0cm×6.0cm的暗紫色肿物,与腹主动脉粘连紧密,切除困难,取部分瘤组织送病理,报告为输尿管转移性肾细胞癌。 例2.患者男,42岁。因体检发现右肾下极占位性病变于1993年8月入院。静脉肾盂造影双输尿管未见异常,尿细胞学检查有一次找到可疑肿瘤细胞。临床诊断为右肾肿瘤。同月行右肾根治性切除术,切除上段输尿管约15.0cm,输尿管残端肉眼未发现异常。术后病理报告为右肾透明细胞癌,输尿管残端有癌细胞浸润。术后2周行残端输尿管及膀胱袖状切除术。残端输尿管病理报告为转移性肾透明细
Renal cancer ureteral metastasis is very rare, a total of 52 cases were reported abroad. From 1988 to 1998, the authors treated a total of 3 cases and are reported as follows: Example 1. Female patient, 41 years old. Left renal cancer 2 years after surgery, left lumbar painless mass with intermittent gross hematuria February in 1990 December admission. Physical examination: left ureter walking area can reach about 7.0cm × 6.0cm mass, hard texture, the surface is still smooth, poor mobility, no tenderness. Urinary routine red blood cells full field, B ultrasound report of the real abdomen mass. Cystoscopy showed left ureteral orifice spurting, left ureter retrograde angiography showed irregular filling of the left ureteral stump defect. Clinical diagnosis of left ureteral stump cancer. Intraoperative see the medial left colon with a size of about 8.0cm × 7.0cm × 6.0cm dark purple tumor, adhesions with the abdominal aorta closely, difficult to remove, take part of the tumor tissue sent to the pathology, reported as ureteral metastatic renal cell carcinoma. Example 2 patient male, 42 years old. Because of physical examination found that the right renal sub-maxillary lesions were admitted in August 1993. Intravenous pyelography double ureter no exception, urine cytology once found suspicious tumor cells. Clinical diagnosis of right kidney tumors. The same month underwent radical nephrectomy, resection of the upper ureter about 15.0cm, ureteral stumps were found no abnormalities. Postoperative pathology report of right renal clear cell carcinoma, ureteral stump cancer cell infiltration. Two weeks after surgery stump ureter and bladder sleeve resection. Stump ureter pathology report of metastatic renal clear thin