上泌尿道非惡性腫瘤-術前評估疑似惡性腫瘤之臨床特徵
盧則宏、歐建慧
國立成功大學醫學院附設醫院 泌尿部
Clinical features of patients with non-malignant
upper tract lesions mimicking urothelial cancer
Ze-Hong Lu , Chien-Hui Ou
Department of Urology, National Cheng Kung University Hospital, College of Medicine,
National Cheng Kung University, Tainan, Taiwan
Purpose: The aim of this retrospective study was to evaluate the incidence and clinical features of
patients undergone nephroureterectomy with non-malignant upper tract lesions presumed to be urothelial carcinoma. The clinicopathologic characteristics of these lesions were also determined.
Material and methods: Between Oct 2004 and Oct 2015, 350 patients underwent retroperitoneoscopic
nephroureterectomy for possible upper urinary tract urothelial carcinoma without routinely ureteroscopic biopsy of lesions at our institute. Twenty-three (6.6%) had non-malignant benign lesions at the final
pathologic examination. The preoperative features of these patients were investigated, including imaging findings, urine cytologic results, and renal function status and previous history.
Results: The 23 patients comprised 9 men and 14 women. Initial symptoms included gross hematuria,
hydronephrosis or repeated pyelonephritis. Urine cytology were also collected for evaluation. We also
reviewed available abdomen computed tomography and retrograde pyelogram. Three patients underwent preoperative ureteroscopy. 11 patients (including 2 patient was post kidney transplantation status) had
non-functional kidney. We divided patient into two groups by renal function status. The most common
pathologic feature of ESRD group is atrophic kidney. In the other hand, the most common diagnosis of
the other group of non-ERSD is pyelonephritis.
Conclusion: Non-malignant pathologic lesions were detected in twenty-three (6.6%) patients who had
undergone retroperitoneoscopic nephroureterectomy without preoperative ureteroscopic biopsies of uppertract lesions.