PDF(Pubmed)
Abstract：
UNASSIGNED: Mucinous neoplasms are tumors arising in the epithelial tissue, characterized by excessive mucin secretion. They mainly emerge in the digestive system and rarely in the urinary system. They also seldom develop in the renal pelvis and the appendix asynchronously or simultaneously. The concurrence of this disease in these two regions has not yet been reported. In this case report, we discuss the diagnosis and treatment of synchronous mucinous neoplasms of the right renal pelvis and the appendix. The mucinous neoplasm of the renal pelvis was preoperatively misdiagnosed as pyonephrosis caused by renal stones, and the patient underwent laparoscopic nephrectomy. Herein, we summarize our experience with this rare case in combination with related literature.
UNASSIGNED: In this case, A 64-year-old female was admitted to our hospital with persistent pain in the right lower back for over a year. Computer tomography urography (CTU) showed that the patient was confirmed as right kidney stone with large hydronephrosis or pyonephrosis, and appendiceal mucinous neoplasm (AMN). Subsequently, the patient was transferred to the gastrointestinal surgery department. Simultaneously, electronic colonoscopy with biopsy suggested AMN. Open appendectomy plus abdominal exploration was performed after obtaining informed consent. Postoperative pathology indicated low-grade AMN (LAMN) and the incisal margin of the appendix was negative. The patient was re-admitted to the urology department, and underwent laparoscopic right nephrectomy because she was misdiagnosed with calculi and pyonephrosis of the right kidney according to the indistinctive clinical symptoms, standard examination of the gelatinous material, and imaging findings. Postoperative pathology suggested a high-grade mucinous neoplasm of the renal pelvis and mucin residing partly in the interstitium of the cyst walls. Good follow-up results were obtained for 14 months.
UNASSIGNED: Synchronous mucinous neoplasms of the renal pelvis and the appendix are indeed uncommon and have not yet been reported. Primary renal mucinous adenocarcinoma is very rare, metastasis from other organs should be first considered, especially in patients with long-term chronic inflammation, hydronephrosis, pyonephrosis, and renal stones, otherwise, misdiagnosis and treatment delay may occur. Hence, for patients with rare diseases, strict adherence to treatment principles and close follow-up are necessary to achieve favorable outcomes.
UNASSIGNED: In this case, A 64-year-old female was admitted to our hospital with persistent pain in the right lower back for over a year. Computer tomography urography (CTU) showed that the patient was confirmed as right kidney stone with large hydronephrosis or pyonephrosis, and appendiceal mucinous neoplasm (AMN). Subsequently, the patient was transferred to the gastrointestinal surgery department. Simultaneously, electronic colonoscopy with biopsy suggested AMN. Open appendectomy plus abdominal exploration was performed after obtaining informed consent. Postoperative pathology indicated low-grade AMN (LAMN) and the incisal margin of the appendix was negative. The patient was re-admitted to the urology department, and underwent laparoscopic right nephrectomy because she was misdiagnosed with calculi and pyonephrosis of the right kidney according to the indistinctive clinical symptoms, standard examination of the gelatinous material, and imaging findings. Postoperative pathology suggested a high-grade mucinous neoplasm of the renal pelvis and mucin residing partly in the interstitium of the cyst walls. Good follow-up results were obtained for 14 months.
UNASSIGNED: Synchronous mucinous neoplasms of the renal pelvis and the appendix are indeed uncommon and have not yet been reported. Primary renal mucinous adenocarcinoma is very rare, metastasis from other organs should be first considered, especially in patients with long-term chronic inflammation, hydronephrosis, pyonephrosis, and renal stones, otherwise, misdiagnosis and treatment delay may occur. Hence, for patients with rare diseases, strict adherence to treatment principles and close follow-up are necessary to achieve favorable outcomes.
摘要：
■粘液性肿瘤是在上皮组织中产生的肿瘤，以分泌过多的粘蛋白为特征。它们主要出现在消化系统中，很少出现在泌尿系统中。它们也很少在肾盂和阑尾中异步或同时发展。尚未报道在这两个地区同时发生这种疾病。在这个案例报告中,我们讨论了右肾盂和阑尾的同步粘液性肿瘤的诊断和治疗。肾盂黏液性肿瘤术前误诊为肾结石引起的脓肾,患者接受了腹腔镜肾切除术。在这里，我们结合相关文献总结了我们对这一罕见病例的经验。
■在这种情况下，一名64岁的女性因右下背部持续疼痛而入院。计算机断层扫描尿路造影（CTU）显示患者被证实为右肾结石伴巨大肾积水或肾积脓，阑尾黏液性肿瘤（AMN）。随后，患者被转移到胃肠外科。同时,电子结肠镜活检提示AMN。在获得知情同意后进行开腹阑尾切除术加腹部探查。术后病理提示低级别AMN（LAMN），阑尾切缘阴性。病人重新入住泌尿科,因临床症状不明显误诊为右肾结石和肾积脓，接受了腹腔镜右肾切除术，凝胶状材料的标准检查，和成像发现。术后病理提示肾盂高度粘液性肿瘤，部分粘蛋白位于囊肿壁的间质中。随访14个月,取得良好的效果。
■肾盂和阑尾的同步性粘液性肿瘤确实不常见，尚未有报道。原发性肾黏液腺癌非常罕见，应该首先考虑其他器官的转移，尤其是长期慢性炎症患者，肾积水,脓肾,和肾结石，否则,可能出现误诊和延误治疗。因此，对于患有罕见疾病的患者，严格遵守治疗原则和密切随访是取得良好结果的必要条件。
■在这种情况下，一名64岁的女性因右下背部持续疼痛而入院。计算机断层扫描尿路造影（CTU）显示患者被证实为右肾结石伴巨大肾积水或肾积脓，阑尾黏液性肿瘤（AMN）。随后，患者被转移到胃肠外科。同时,电子结肠镜活检提示AMN。在获得知情同意后进行开腹阑尾切除术加腹部探查。术后病理提示低级别AMN（LAMN），阑尾切缘阴性。病人重新入住泌尿科,因临床症状不明显误诊为右肾结石和肾积脓，接受了腹腔镜右肾切除术，凝胶状材料的标准检查，和成像发现。术后病理提示肾盂高度粘液性肿瘤，部分粘蛋白位于囊肿壁的间质中。随访14个月,取得良好的效果。
■肾盂和阑尾的同步性粘液性肿瘤确实不常见，尚未有报道。原发性肾黏液腺癌非常罕见，应该首先考虑其他器官的转移，尤其是长期慢性炎症患者，肾积水,脓肾,和肾结石，否则,可能出现误诊和延误治疗。因此，对于患有罕见疾病的患者，严格遵守治疗原则和密切随访是取得良好结果的必要条件。
