Radiographic Features of Intrinsic Ureteral Endometriosis: A Case Report

內生性輸尿管子宮內膜異位在醫學影像之表現：病例報告

王明宗(Ming-Tsung Wang) ； 麥志輝(Chee-Wai Mak) ； 曾文盛(Wen-Sheng Tzeng) ； 陳志程(Jyh-Ching Chen) ； 張晉民(Jinn-Ming Chang) ； 蘇正川(Chang-Chuan Su)

《中華放射線醫學雜誌》 30卷1期 (2005/02) Pp. 59-63

摘要

子宮內膜異位常見於卵巢、輸卵管及骨盆腔，但較少見於輸尿管。輸尿管子宮內膜異位可以分為內生性和外生性兩種型態，其中內生性型態又更少發生，但因為這種型態在醫學影像上常和惡性的輸尿管移型上皮癌相似，而使病人接受不必要的手術。我們報告一病例病理證明為內生性輸尿管子宮內膜異位，順行性腎盂造影看到一管狀的遠端輸尿管缺損病灶，電腦斷層發現一個軟組織腫瘤在遠端輸尿管。雖然內生性輸尿管子宮內膜異位並不常見，但當一育齡婦女發現有上述影像學的表徵時，應將內生性輸尿管子宮內膜異位列入鑑別診斷。

關鍵字

子宮內膜異位 ； 輸尿管，狹窄或阻塞 ； 尿路攝影

並列摘要

Endometriosis is defined as the presence of endometrial tissue in an ectopic position. It occasionally involves the urinary tract. Ureteral endometriosis may be either intrinsic or extrinsic, where the intrinsic ureteral endometriosis refers to disease caused by the actual invasion of the ureteral wall by the endometriosis. This form has often been mistaken for a primary ureteral neoplasm, with consequent nephroureterectomy. We reported a case of ureteral endometriosis in a 47 year-old female patient suffered from unilateral hydronephrosis. Left antegrade pyelography revealed a tubular filling defect in the left distal ureter with left hydronephrosis, and computed tomography (CT) demonstrated a soft tissue in the left distal ureter. Under the impression of malignant urothelial tumor, segmental resection of distal ureter was performed. The pathologic findings revealed elements of endometrial glands and stroma in the ureteral lumen. Extragenital intraureteral endometriosis was diagnosed. We should be aware of such diagnostic pitfalls to distinguish this lesion from polypoid ureteral tumor before operation.

並列關鍵字

Endometriosis ； Ureter, stenosis obstruction ； Urography