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目的探讨单纯输尿管原位癌(carcinoma in situ,CIS)的临床特点及诊断治疗。方法总结1例单纯输尿管CIS患者的临床资料并复习相关文献。患者因左侧腰部及下腹部疼痛3周入院。超声提示左肾盂积水,CT提示左侧输尿管下段软组织占位,伴不均匀强化。结果患者行输尿管下段肿物切除、输尿管再吻合术,术后病理报告为输尿管CIS,患者术后1周痊愈出院。术后随访2年未见肿瘤复发转移。结论 CIS通常合并于移行上皮癌,单纯输尿管CIS少见,术前确诊较困难,术后膀胱癌发生率高。治疗应采取根治性肾输尿管全长切除+膀胱袖状切除术,术后应定期复查膀胱癌复发情况。
Objective To investigate the clinical features and diagnosis of simple ureteral carcinoma in situ (CIS). Methods One case of CIS with simple ureteral calculi was reviewed and the relevant literature was reviewed. The patient was admitted to the hospital for 3 weeks because of pain in the lower left and lower abdomen. Ultrasound prompted left hydronephrosis, CT prompted the lower ureter soft tissue mass, with uneven enhancement. Results The patients underwent ureteral removal of the tumor and ureter re-anastomosis. The postoperative pathological report was ureteral CIS. The patients were cured and discharged one week after operation. No recurrence and metastasis was observed after 2 years of follow-up. Conclusion CIS is usually associated with transitional cell carcinoma. CIS is rare in simple ureter, and it is difficult to diagnose before operation. The incidence of postoperative bladder cancer is high. Treatment should be taken radical nephroureterectomy + bladder sleeve resection, postoperative bladder cancer recurrence should be reviewed regularly.