Analysis of 7 cases of delayed diagnosis of primary upper tract urothelial carcinoma with calculi
10.3969/j.issn.1009-8291.2023.08.005
- VernacularTitle:伴发结石的原发性上尿路尿路上皮癌患者延迟诊断7例分析
- Author:
Bin JIN
1
;
Zhengtong LYU
1
;
Miao WANG
1
;
Pengjie WU
1
;
Hong MA
1
;
Xin CHEN
1
;
Ming LIU
1
Author Information
1. Department of Urology, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
upper tract urothelial carcinoma;
urinary calculi;
carcinoma of the ureter;
carcinoma of renal pelvis
- From:
Journal of Modern Urology
2023;28(8):665-669
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To reduce the misdiagnosis rate by analyzing the clinical data of patients with primary upper tract urothelial carcinoma (UTUC) complicated with calculi. 【Methods】 Clinical data of 7 UTUC with calculi patients treated during Sep.2018 and Apr.2022 were retrospectively analyzed, including general data, time from visit to diagnosis, imaging data, urine exudation cytological results, surgical methods, pathological stages and follow-up data. 【Results】 The ratio of male to female was 3∶4, and the mean age was 66.4 (55-72) years. The initiate imaging examination results only showed calculi, but did not indicate suspicious tumor (including 1 case with missing data). The median time from the first visit to diagnosis was 12 months (5-36 months). Of all 7 cases, 2 (2/4) were clinically diagnosed by enhanced CT, 3 (3/4) by MRI, and 2 (2/7) by positive urine exudation cytology. All patients received surgical treatment. Postoperative pathology showed 85.71% (6/7) were high-grade UTUC. Postoperative staging was T1N0M0 in 4 cases, T3N0M0 in 2 cases, and T4N2M0 in 1 case. Adjuvant chemotherapy was conducted in 2 cases. During the median follow-up of 12 months (6-41), 1 case developed multiple systemic metastases in month 9, while the other cases had no recurrence or metastasis. 【Conclusion】 For UTUC patients without obvious filling defect on imaging, especially when ipsilateral calculi were complicated, misdiagnosis should be alerted for timely treatment and better prognosis.
