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目的探讨肾盂鳞状细胞癌伴同侧输尿管鳞癌的临床病理特征。方法回顾性分析2例肾盂鳞癌伴同侧输尿管鳞癌患者的临床病理资料。病例1男,68岁,血尿1月入院,CT检查示右肾盂及输尿管下段占位,行根治性肾输尿管切除加膀胱袖套状切除术。病例2男,60岁,左腰部及左下腹痛1月外院诊断为左输尿管结石行输尿管切开取石术,术中见输尿管下段肿物,活检示鳞状细胞癌,转我院手术。术中见左肾下极肿物伴结肠侵犯,行根治性肾输尿管切除膀胱袖套状切除左半结肠切除及扩大淋巴结清扫术。2例患者术后均未行放化疗。结果病理报告病例1肾盂及输尿管均为中分化鳞癌,侵及肾盂黏膜下层及输尿管浅肌层。病例2肾盂中分化鳞癌,结肠受侵,输尿管下段低分化鳞癌,伴腹膜后淋巴结转移。分别于术后5个月和6个月死于肿瘤复发转移。结论肾盂鳞状细胞癌伴同侧输尿管鳞状细胞癌临床罕见,早期诊断困难,术后短期内易复发转移,预后极差。
Objective To investigate the clinicopathological features of squamous cell carcinoma of renal squamous cell carcinoma with ipsilateral ureteral squamous cell carcinoma. Methods The clinical data of 2 patients with squamous cell carcinoma of the renal pelvis and ipsilateral ureteral squamous cell carcinoma were retrospectively analyzed. Case 1 male, 68 years old, hematuria hospitalized in January, CT showed the right renal pelvis and ureter in the next segment, radical nephroureterectomy and cuff surgery. Case 2 male, 60 years old, left lower back and left lower abdominal pain 1 month outside the hospital diagnosed as left ureteral calculi ureterolithotomy surgery see the lower ureter tumor, biopsy showed squamous cell carcinoma, transferred to our hospital. Intraoperative see the left renal subarachnoid with colon invasion, radical nephroureterectomy bladder cuff-like resection of the left half colon resection and expansion of lymph node dissection. Both patients did not receive radiotherapy and chemotherapy after operation. Results Pathology report cases 1 renal pelvis and ureter are differentiated squamous cell carcinoma, invasion and renal pelvic submucosa and ureteral superficial muscle. Case 2 differentiated squamous cell renal pelvis, colon invasion, poorly differentiated squamous cell carcinoma of the lower ureter, with retroperitoneal lymph node metastasis. Respectively 5 and 6 months after surgery died of tumor recurrence and metastasis. Conclusions The diagnosis of renal squamous cell carcinoma with ipsilateral ureteral squamous cell carcinoma is rare. It is difficult to diagnose early. It is easy to recur and metastasis in short term after operation. The prognosis is very poor.