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目的探讨经皮肾镜取石术(PCNL)漏诊肾盂鳞状细胞癌的原因及诊断对策。方法自2000年2月至2009年12月采用经皮肾镜取石术(PCNL)治疗上尿路结石1250例,其中2例术后病情反复不愈,最终诊断为肾结石并肾盂鳞状细胞癌,本文回顾性分析2例肾结石并肾盂鳞状细胞癌患者诊治的临床资料。结果 2例患者均有结石病史长,伴感染、积水及顽固性疼痛等临床表现,PCNL术后1个月经改开放手术病理诊断为肾结石并肾盂鳞状细胞癌。结论微创PCNL手术时不能忽视肾结石并发肿瘤的可能性,重视临床症状及术中病理,是防止出现漏诊误诊的关键。
Objective To investigate the causes of missed diagnosis of squamous cell carcinoma of the kidney with percutaneous nephrolithotomy (PCNL) and its diagnosis. Methods From January 2000 to December 2009, 1250 cases of upper urinary tract calculi were treated with percutaneous nephrolithotomy (PCNL), of which 2 cases were repeatedly unhealed and finally diagnosed as renal calculi and renal squamous cell carcinoma This article retrospectively analyzed 2 cases of renal calculi and renal squamous cell carcinoma diagnosis and treatment of clinical data. Results Both of the two patients had long history of stone disease with clinical manifestations such as infection, hydrocephalus and intractable pain. One month after PCNL surgery, they were diagnosed as renal calculi and squamous cell carcinoma of renal squamous cell carcinoma by pathology. Conclusions Minimally invasive PCNL surgery can not ignore the possibility of nephrolithiasis and tumor, and pay attention to clinical symptoms and intraoperative pathology, which is the key to prevent misdiagnosis.