Carcinoma urotelial de tracto urinario superior: reporte de un caso

Jorge Lambis Ricardo, Sandra Herrera Lomónaco, Carlos Ballestas Almario, Alfredo Mendoza Luna, Stephany Montenegro Castañeda, Aura González Peralta

DOI: https://doi.org/10.32997/rcb-2015-2966

Resumen

Introducción: los carcinomas uroteliales de tracto urinario superior primarios son tumores raros, representan el 5% de todos los cánceres uroteliales y menos del 10% de los tumores renales. Los síntomas son inespecíficos. Son más frecuentes en la 7-8º década de la vida. El pronóstico es pobre para los pacientes con enfermedad avanzada.
Caso clínico: masculino de 55 años con hematuria microscópica y dolor lumbar. Ureterorrenoscopia flexible muestra sangrado difuso proveniente de las papilas de cáliz
superior, asociado a lesión de características tumorales. Se realiza nefrectomía abierta izquierda con ureterotomía izquierda. Estudio anatomopatológico reportó carcinoma urotelial invasivo de tracto urinario superior. El paciente presentó evolución satisfactoria.
Conclusión: el carcinoma urotelial del tracto superior es una enfermedad rara. Es importante la clasificación y estadificación preoperatoria precisa. El tratamiento de elección es la  nefroureterectomía. Rev.cienc.biomed. 2015;6(2):364-368


Palabras clave

Carcinoma urotelial; Pelvis renal; Nefroureterectomía radical; Ureteroscopia.

Texto completo:

PDF

Referencias

Roupret M, Babjuk M, Comperat E, Zigeuner R, Sylvester R, Burger M, et al. European guidelines on upper tract urothelial carcinomas: 2013 update. European urology. 2013;63(6):1059-

Epub 2013/04/02.

Patel N, Arya M, Muneer A, Powles T, Sullivan M, Hines J, et al. Molecular aspects of upper tract urothelial carcinoma. Urologic oncology. 2014;32(1):28 e11-20. Epub 2013/02/23.

Shariat SF, Favaretto RL, Gupta A, Fritsche HM, Matsumoto K, Kassouf W, et al. Gender differences in radical nephroureterectomy for upper tract urothelial carcinoma. World journal of urology. 2011;29(4):481-6. Epub 2010/10/05.

Colin P, Koenig P, Ouzzane A, Berthon N, Villers A, Biserte J, et al. Environmental factors involved in carcinogenesis of urothelial cell carcinomas of the upper urinary tract. BJU international.

;104(10):1436-40. Epub 2009/08/20.

Inman BA, Tran VT, Fradet Y, Lacombe L. Carcinoma of the upper urinary tract: predictors of survival and competing causes of mortality. Cancer. 2009;115(13):2853-62. Epub 2009/05/13.

Cowan NC. CT urography for hematuria. Nature reviews Urology. 2012;9(4):218-26. Epub 2012/03/14.

Ito Y, Kikuchi E, Tanaka N, Miyajima A, Mikami S, Jinzaki M, et al. Preoperative hydronephrosis grade independently predicts worse pathological outcomes in patients undergoing nephroureterectomy for upper tract urothelial carcinoma. The Journal of urology. 2011;185(5):1621-6. Epub 2011/03/23.

Raman JD, Shariat SF, Karakiewicz PI, Lotan Y, Sagalowsky AI, Roscigno M, et al. Does preoperative symptom classification impact prognosis in patients with clinically localized upper-tract urothelial carcinoma managed by radical nephroureterectomy? Urologic oncology. 2011;29(6):716-23. Epub 2010/01/09.

Tai Y-S, Chiang IN, Huang C-Y, Tai H-C, Pu Y-S. Effectiveness of different diagnostic tools for upper urinary tract urothelial carcinoma. Urological Science. 2015;26(1):57-60.

Remzi M, Shariat S, Huebner W, Fajkovic H, Seitz C. Upper urinary tract urothelial carcinoma: what have we learned in the last 4 years? Therapeutic Advances in Urology. 2011;3(2):69-80.

McLaughlin JK, Silverman DT, Hsing AW, Ross RK, Schoenberg JB, Yu MC, et al. Cigarette smoking and cancers of the renal pelvis and ureter. Cancer research. 1992;52(2):254-7. Epub 1992/01/25.

Grollman AP, Shibutani S, Moriya M, Miller F, Wu L, Moll U, et al. Aristolochic acid and the etiology of endemic (Balkan) nephropathy. Proceedings of the National Academy of Sciences of the United States of America. 2007;104(29):12129-34. Epub 2007/07/11.

Humphrey PA. Urothelial carcinoma of the upper urinary tract. The Journal of urology. 2014;192(4):1223-4. Epub 2014/07/22.

Olgac S, Mazumdar M, Dalbagni G, Reuter VE. Urothelial carcinoma of the renal pelvis: a clinicopathologic study of 130 cases. The American journal of surgical pathology. 2004;28(12):1545-52. Epub 2004/12/04.

Perez-Montiel D, Wakely PE, Hes O, Michal M, Suster S. High-grade urothelial carcinoma of the renal pelvis: clinicopathologic study of 108 cases with emphasis on unusual morphologic variants. Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc. 2006;19(4):494-503. Epub 2006/02/14.

Bostwick DG, Cheng L. Urologic Surgical Pathology. 2 ed: Elsevier Health Sciences; 2008.

Chromecki TF, Bensalah K, Remzi M, Verhoest G, Cha EK, Scherr DS, et al. Prognostic factors for upper urinary tract urothelial carcinoma. Nature reviews Urology. 2011;8(8):440-7. Epub 2011/07/06.

Painter DJ, Timoney AG, Denton K, Alken P, Keeley FX, Jr. The modern management of upper urinary tract urothelial cancer: tumour diagnosis, grading and staging. BJU international. 2007;99(5):973-7. Epub 2007/04/18.

Streem SB, Pontes JE, Novick AC, Montie JE. Ureteropyeloscopy in the evaluation of upper tract filling defects. The Journal of urology. 1986;136(2):383-5. Epub 1986/08/01.

Painter DJ, Denton K, Timoney AG, Keeley FX. Ureteroscopic management of upper-tract urothelial cancer: an exciting nephron-sparing option or an unacceptable risk? Journal of endourology

/ Endourological Society. 2008;22(6):1237-9. Epub 2008/06/27.


Enlaces refback

  • No hay ningún enlace refback.