UNASSIGNED: Herein, we report a case of MPM with occult onset presenting with bilateral hydronephrosis and renal insufficiency. A 30-year-old man was admitted to the Urology Department because of recurrent bilateral lower back pain. The etiology was unclear after a series of laboratory tests, imaging examinations, bone marrow aspiration, renal puncture biopsy, ascites examination, ureteroscopy, and so on. Finally, MPM was diagnosed by laparoscopic exploration and biopsy. Moreover, during the course of the disease, the patient\'s bilateral ureters were compressed, and the obstruction could not be relieved after the placement of ordinary ureteral stents. Percutaneous nephrostomy or metal ureteral stenosis was appropriate in managing malignant ureteral obstruction as it could improve renal function.
UNASSIGNED: The onset of this case was insidious, and the diagnosis was difficult, with a poor prognosis. To date, only a handful of cases have been reported. We hope this case can provide some enlightenment for our clinical work.
■这里,我们报告了一例隐匿性发作的MPM,表现为双侧肾积水和肾功能不全。一名30岁的男子因反复发作的双侧下背部疼痛而被送往泌尿外科。经过一系列的实验室检查,病因尚不清楚,影像学检查,骨髓穿刺,肾穿刺活检,腹水检查,输尿管镜检查,等等。最后,通过腹腔镜探查和活检诊断为MPM。此外,在疾病的过程中,患者双侧输尿管受压,放置普通输尿管支架后,梗阻不能缓解。经皮肾造口术或金属输尿管狭窄适用于治疗恶性输尿管梗阻,因为它可以改善肾功能。
■这个病例的发病是阴险的,诊断很困难,预后不良。迄今为止,只有少数病例报告。希望该病例能为我们的临床工作提供一些启示。