Transitional Cell Carcinoma of Native Kidney and Urinary Bladder With Metastasis to Graft Kidney: Report of a Case

接受腎臟移植及術後及術後抑制治療的病人是罹患癌症的高危險群，但此類病人罹患泌尿道移行上皮細胞癌的機率是相當低的。在本院統計240例接受腎臟移植病患中，僅有一位病患其原有的腎臟、膀胱及移植腎皆長出移行性上皮細胞癌，亦是文獻上第一例如此廣泛轉移之病例報告。此位接受腎臟移植及術後免疫抑制治療之22歲女性病患因血尿及反履尿道感染而經常住院，並於血尿發生的五個月後發現其原有的腎臟及膀胱皆長出移行性上皮細胞癌。雖然病患很快地接受了經尿道膀脫腫瘤切除及固有腎臟輸尿管切除術，此腫瘤仍於三個月能轉移至移植腎併大腸侵犯及靜脈腫瘤拴塞。即使病患接受了另一次外科手術切除，此腫瘤仍快速地轉移至全身各器官，最後並導致病患死亡。是以我們提出此病例並討論治療上的一些問題。”

關鍵字

腎臨移植；腎臨切除術；移行性上皮細胞癌

並列摘要

Iatrogenic immunosuppression following renal transplantation has been associated with the development and progression of multiple neoplasms, such as transitional cell carcinoma (TCC). We present a 22-year-old woman with a cadaveric renal transplant, who experienced rapid progression of TCC from hematuria to a mass lesion in the native right renal pelvis, ureter, and urinary bladder during a 5-month period. Transurethral resection of the bladder tumor and right native nephrectomy with bladder cuff excision were performed. However, TCC of the graft kidney with tumor thrombosis of her allograft renal vein as well as in the right femoral vein developed within 3 months. Although sacrifice of the graft kidney and excision of the extensive pelvic tumor were performed, the patient died of multiple organ metastases 2 months after excision. Attempted resection and chemotherapy were abandoned. Because of nature of unusually rapid extension of urothelial cancer in renal transplantation recipients, the necessity of early diagnosis and aggressive treatment of malignancy are suggested.

並列關鍵字

kidney transplantation ； nephrectomy ； transitional cell carcinoma

國際替代計量

Transitional Cell Carcinoma of Native Kidney and Urinary Bladder With Metastasis to Graft Kidney: Report of a Case

全文下載

主題瀏覽