完全雙套輸尿管的尿路上皮癌
許智凱、張廷瑞、陳世亮
台南市立醫院 泌尿科
UTUC in A Complete Duplicated Collecting System - A rare case report
Chih-Kai Hsu, Ting-Jui Chang, Shih-Liang Chen
Divisions of Urology, Tainan Municipal Hospital, Tainan, Taiwan
Background: Primary UTUC is relative rare in western countries and more frequent in Taiwan. The co-existence of UTUC and bilateral duplex collecting system (DCS) is extremely rare. We reported a case of UTUC in a complete DCS.
Case Report: A 70 years-old lady has painless gross hematuria for 1 month. Bilateral complete DCS was noted by CT scan, and a 3 cm mass in the renal pelvis of upper moiety. Laparoscopic nephroureterectomy was performed successfully. Pathology showed a T3 disease with renal parenchymal invasion, therefore she received adjuvant chemotherapy one month after surgery.
Discussion: In literature reviewed, UTUC is account for 5%~10% of all renal neoplasms, and 1% of all genitourinary tumors. The incidence of DCS is around 1/150. Only 17 cases of UTUC that developed inside a DCS were reported. And only 1 case had synchronized bilateral UTUC in DCS. In the 17 cases, most tumors were located at ureter (11/17) 61%, unilateral DCS (15/18) 83%. The surgical treatments are Nephroureterectomy, hemi-nephroureterectomy, segmental ureterectomy options depend on tumor’s location. Surgeries may be more difficult than the usual cases, due to anatomic disorientation and complexity of the renal hilar vessels.