关键词: 肾实质浸润；尿路上皮癌；诊断；手术；预后

Abstract:

Objective  To discuss the diagnosis and treatment of the invasive renal parenchyma urothelial carcinoma (IRPUC). Methods  The clinical data of 8 cases of IRPUC were reviewed retrospectively. Of all patients, 6 were male and 2 were female, aged 43～78 years, mean 64 years. The carcinomas were located at the left in 3 cases and at the right in 5 cases, with the diameter being 3.0～8.5cm, mean 5.2cm. According to WHO grading system, 2 cases were in G2 and 6 cases were in G3. According to the TNM clinical stage, 2 cases were in stage Ⅲ and 6 cases in stage Ⅳ.  ResultsFour patients received nephroureterectomy with bladder partly excision, and the other 4 underwent nephrectomy, among whom 1 case also received adrenalectomy and postcava tumor excision. Postoperative pathology showed that all cases were urothelial carcinoma, and 2 cases were complicated with squamous differentiation. Altogether 6 cases had metastasis in renal capsule, 4 in renal portal, 3 in ureter, 1 in postcava and adrenal gland, and 1 in bladder. During the follow-up of 3 months to 4 years, 6 cases died, with an average survival time of 9 months; the other 2 cases survived for 13 months and 4 years respectively. Conclusion  Invasive renal parenchyma urothelial carcinoma is prone to infiltration and metastasis with poor prognosis. As early imaging diagnosis is difficult, exploratory operation is significant for confirmed diagnosis and better prognosis.

Key words: Renal parenchyma invasion; Urothelial carcinoma; Diagnosis; Operation; Prognosis