Adenocarcinoma of the Lung with Bilateral Hydroureteronephrosis

肺腺癌合併兩側輸尿管阻塞及水腎－病例報告

林偉群(Wei-Chun Lin) ； 邱昭華(Chao-Hua Chiu) ； 蔡俊明(Chun-Ming Tsai)

《胸腔醫學》 21卷3期 (2006/06) Pp. 286-290

https://doi.org/10.29806/TM.200606.0010

摘要

本文報告一肺癌病例於生前被發現有兩側輸尿管及陰道轉移。病患是一位53歲女性肺癌患者因為急性腎衰竭住院，腎臟超音波顯示有兩側輸尿管阻塞及腎臟積液，腎功能於經皮置放腎臟pig-tail導管引流尿液後恢復正常。尿液細胞學檢查顯示為腺癌細胞。而相關影像學檢查（腹腔電腦斷層及後腹腔核磁共振）顯示無腎臟、後腹腔淋巴結轉移或是後腹腔腫瘤壓迫輸尿管。原發性腫瘤造成輸尿管阻塞常見的是子宮頸癌，攝護腺癌、膀胱癌及大腸直腸癌，肺癌合併兩側輸尿管阻塞及腎臟積液實為少見，只有少數病例是在生前診斷出來。而隨著肺癌治療的進步，肺癌病人的生命延長，預期一些往昔肺癌罕見的臨床表現會愈來愈多，我們報告這樣的病人以提醒大家肺腺癌病人可能有此罕見的輸尿管轉移。

關鍵字

肺癌 ； 水腎 ； 輸尿管阻塞

並列摘要

We report a 53-year-old female who was diagnosed with adenocarcinoma of the lung and failed to respond to 2 lines chemotherapy. She developed oliguric acute renal failure within 1 week. A renal sonography disclosed bilateral hydroureteronephrosis. She underwent a bilateral percutaneous nephrostomy with external drainage, and her renal function recovered within 3 days. The most common primary sites of cancers causing ureteral obstruction are the cervix, prostate, bladder and colo-rectum. To our knowledge, few case reports of ureteral obstruction attributable to lung cancer have been published. With the current improvements in lung cancer management, survival time has been significantly prolonged and unusual presentations or complications of lung cancer are becoming more common than before. Physicians should be aware that hydronephrosis could complicate the course of patients with non-small cell lung cancer.

並列關鍵字

lung cancer ； hydronephrosis