泌尿男生殖系多原发恶性肿瘤(附39例报告)

目的 探讨泌尿男生殖系多原发恶性肿瘤的临床特点。方法 对１９７２年１月～１９９８年１２月收治的３９例多原发恶性肿瘤患者的临床资料进行回顾性分析。结果 本组多原发恶性肿瘤的发生率为５．０％，平均发病年龄６５岁（第一癌），第一癌与第二癌平均间隔３．７年。３４例随访０．３～１６．５年，平均６．４年。１９例死亡，直接死因为第二癌者１６例。结论 多原发恶性肿瘤在泌尿外科并不少见，对第二癌的诊疗应引起重视。     

泌尿生殖系多原发恶性肿瘤15例报告

目的：探讨泌尿生殖系多原发恶性肿瘤（MPN）的相关问题。方法：对15例泌尿生殖系MPN患者临床资料进行回顾性分析，并结合文献复习就其诊断标准、发病情况、发病因素及预后进行了讨论。结果：第2癌切除术后生存1．5年者1例，2年者1例，3年以上者2例，5年者2例。结论：MPN的预后与转移癌不一样，鉴别多发癌是多原发癌还是转移癌具有重要的临床意义。     

双侧多灶性肾癌的长期治疗

肾细胞癌在泌尿生殖系恶性肿瘤中居第三位,并且当其癌肿超出肾脏范围成为非器官局限性病变后,则是泌尿男生殖系中致死性最强的恶性肿瘤。2009年,美国有57000例患者被诊断为肾癌,其中有13000人被夺去了生命[1]。肾癌的发病率可能会以每年3%的速度增长[2,3]     

泌尿生殖系相关的多原发恶性肿瘤21例分析

目的探讨与泌尿生殖系相关的多原发恶性肿瘤(MPMNs)问题。方法对21例与泌尿生殖系相关的MPMNs患者临床资料进行回顾性分析,并结合文献复习就其诊断标准、发病情况、发病因素及预后进行讨论。结果癌切除术后生存1.5年者1例,2年者3例,3年以上者5例,5年者3例。结论MPMNs的预后明显优于单原发恶性肿瘤的复发或转移,鉴别多发癌是多原发癌还是转移癌具有重要的临床意义。     

泌尿及男生殖系横纹肌肉瘤11例报告

报告泌尿及男生殖系横纹肌肉瘤11例,男10例,女1例,发生于肾脏1例,膀胱6例,前列腺2例,睾丸、附睾各1例,其中10例经手术、1例经穿刺活检病理证实为横纹肌肉瘤。经放射治疗或/和化学治疗,结果术后3年死亡3例,2年内死亡3例,1例附睾横纹肌肉瘤患者存活2年,后失访,余各例已存活10月～18月,并结合文献对该病的诊断、治疗及预后进行讨论。     

泌尿男生殖系多原发癌的诊治

目的:提高对同时发生的泌尿男生殖系多原发癌(MPMN)的诊断与治疗水平。方法:回顾性分析20例MPMN患者资料。20例均行手术治疗,其中4例晚期前列腺癌合并浅表性膀胱癌行TURBT+TURP,8例浸润性膀胱癌合并早期前列腺癌行根治性膀胱前列腺全切,4例浸润性膀胱癌合并局部晚期前列腺癌,行膀胱部分切除术+化疗及内分泌治疗。2例肾癌合并晚期前列腺癌均行根治性肾切除+内分泌治疗。1例肾癌伴膀胱癌行肾癌根治+TURBT。1例肾癌合并浸润性膀胱癌行肾癌根治+根治性膀胱全切。结果:病理诊断移行细胞癌18例,前列腺癌18例,肾透明细胞癌3例,乳头状肾癌1例。平均随访36(10～48)个月,12例平均生存23个月,8例无瘤生存。结论:泌尿男生殖系同时性MPMN易漏诊,早发现并采用手术为主的综合治疗可显著提高患者生存期,多瘤共存非预后不良的标志。     

与泌尿及男生殖系相关的多原发恶性肿瘤

多原发恶性肿瘤 (multipleprimarymalignantneoplasms,MPMNs)是一种特殊的肿瘤表现形式 ,自 1 889年Billroth首次报道以来不断有学者对此进行研究。在临床上 ,MPMNs易与恶性肿瘤晚期转移相混淆 ,造成误诊、误治。为提高对它的认识 ,现将与泌尿男生殖系相关的MPMNs综述如下。1 　MPMNs的定义MPMNs是指宿主同时或先后发生两个及两个以上原发恶性肿瘤。按两个肿瘤发现的时间间隔可分为同时性和异时性两种 ,多将间隔 6个月及以内者归为同时性 ,超过 6个月者归为异时性。2 　 流行病学MPMNs的发生率无国家级统计资料 ,文献中报道的均为…     

肾上腺、泌尿男生殖系统恶性淋巴瘤的诊断和处理(附4例报告)

目的 提高肾上腺、泌尿男生殖系恶性淋巴瘤的诊治水平.方法 报告收治的4例患者的临床资料,4例的临床表现和影像学检查均无特异性.2例经手术探查明确诊断,2例在B超导引下行穿刺活检后明确诊断.3例常规行化疗.结果 例1术后随访11月至今,目前仍存活.例2目前已存活4年例3现已存活2年.例4诊断后20天,死于脑转移、肺部感染、感染性休克、呼吸循环衰竭.结论 临床表现和影像学检查缺乏特异性,手术探查、CT或超声导引下的穿刺活检是明确诊断的好方法,治疗要根据病理组织类型和分期的个体化治疗.     

《临床泌尿外科杂志》2001年各期重点

第1期良性前列腺增生第2期泌尿男生殖系肿瘤第3期腔道泌尿外科和内窥镜第4期泌尿系结石的外科治疗第5期泌尿男生殖系结核第6期泌尿系肿瘤 第7期良性前列腺增生第8期肾积水和肾上腺疾病第9期泌尿外科疾病的诊断第10期泌尿外科疾病的治疗第11期肾、输尿管结石第12期新技术、新经验及其他     

中国部分市县膀胱癌发病趋势比较研究

目的 探讨中国大陆膀胱癌发病的流行病学特征. 方法收集整理中国大陆30个肿瘤登记处1988-2002年膀胱癌发病登记的数据资料,选取数据较为齐全的北京、天津、上海、武汉、哈尔滨、河北磁县、江苏启东、浙江嘉善、广西扶绥、福建长乐、河南林州11个登记处的资料,分为1988-1992、1993-1997、1998-2002年3个时间段,比较分析膀胱癌发病率、病死率,采用美国癌症研究所开发的统计软件Joinpoint Regression Program 3.3.1分析其流行趋势.通过对发病率的对数转换线性回归分析计算年度变化百分比. 结果 30个登记处1988-1992、1993-1997、1998-2002年膀胱癌的发病率分别为8.22/10万、9.45/10万、9.68/10万,呈逐年上升趋势,占泌尿男生殖系肿瘤第1位.依据1993-1997年数据,与世界部分国家和地区比较仍处于较低水平. 结论膀胱癌是我国泌尿男生殖系最常见的恶性肿瘤,发病率在15年间呈逐年上升趋势,需引起重视.     

泌尿系相关多原发癌23例临床分析

目的:探讨泌尿系相关多原发癌的病因、发病规律、转归及治疗方法。方法:回顾性分析23例泌尿系相关多原发癌患者的病史、转归及治疗经过。结果:本组发生率为0.63%,其中膀胱肿瘤10例,前列腺癌8例,肾癌5例;同时性多原发癌9例,异时性多原发癌14例。同一患者第一原发癌的恶性程度与第二原发癌的恶性程度相一致;同一肿瘤作为第一原发癌和第二原发癌的恶性程度无差异;发病间隔越短,预后越差。放疗、化疗、内分泌治疗及免疫治疗均可起到一定的治疗效果,接受根治性手术者预后较好。结论:老年患者泌尿系相关多原发癌以伴发消化系肿瘤为主,男性患者居多;第一原发癌与第二原发癌的恶性程度相一致,同时性多原发癌的预后较差;治疗仍以根治性手术切除为主。     

Second malignant neoplasms in patients successfully treated with multimodality treatment for advanced head and neck cancer

One hundred fourteen patients with advanced (stage III or IV) epidermoid carcinoma of the oral cavity, pharynx, larynx, and hypopharynx were treated by surgery and postoperative radiation therapy between 1975 and 1980. Twenty-seven patients also received preoperative platinum-containing chemotherapy. Sixteen patients developed second malignant neoplasms. The site of the second malignant neoplasm was in the esophagus in seven patients (44%), in the lung in six patients (37.5%), and at other sites in three patients (18.5%). Relapse of the head and neck cancer (at the primary site in 6 patients, in the neck in 11 patients, and at distant sites in 20 patients) appeared within the first 2 years in virtually all cases. In contrast, second malignant neoplasms have appeared at a steady rate of approximately 6% per year, for at least the first 4 years. Future efforts at improving the survival of patients with advanced head and neck cancer, therefore, must include strategies aimed at decreasing the incidence and the morbidity and mortality from second malignant neoplasms.     

Delayed metastases in skin cancer of the head and neck: the case of the "known primary"

Regional metastases from head and neck cutaneous tumors are uncommon, and most present within 2 years from initial diagnosis. Occasionally such metastases may manifest at a later date, increasing the possibility of being derived from a second noncutaneous primary cancer of the head and neck region. The authors studied the course of disease in patients treated for cutaneous neoplasms manifesting with delayed regional metastases. They evaluated patients treated for cutaneous neoplasms with regional metastases presenting more than 3 years from initial treatment. There were 10 cases of squamous cell carcinoma, one case of basal cell carcinoma, and one case of basosquamous carcinoma. Mean duration from initial diagnosis to presenting neck metastases was 4 years 2 months. Mean overall follow-up is 2 years 5 months, and 3 years for patients alive without disease. Four patients died of unrelated causes and 3 patients died of their disease. Five patients are alive and free of disease. A diligent search for a second primary must always be carried out when neck metastases appear. Yet, delayed regional metastases appearing more than 3 years after resection of skin neoplasms is not uncommon and are usually associated with the primary skin cancer. Prolonged follow-up is essential, even in T1 patients. Patients with regional recurrence should be treated aggressively.     

多原发大肠癌37例临床分析

目的 探讨多原发大肠癌的临床特点、诊断治疗及预后。方法 对1974-1998年37例多原发大肠癌进行回顾性分析。结果 37例占同期收治原发大肠癌的2．74％(37／1348)，其中同时多原发大肠癌15例，异时多原发大肠癌22例，癌灶部位以右半结肠和直肠为多，异时多原发大肠癌55％(12／22)在3年内发生，41％(9／22)在8年后发生，全部癌灶除1例外均得到根治性切除，同时多原发大肠癌5年生存率为5／9，异时多原发大肠癌5年生存率为15／21，二次癌术后5年生存率为7／18。结论 提高对多原发大肠癌的警惕性，术前全面检查，术中仔细探查，术后定期复查，争取早期发现，积极手术治疗，以提高生存率。     

Primary malignant melanoma of the oral cavity. A review of 20 cases

Twenty patients with primary malignant melanoma of the oral cavity have been described. They formed 3.9 percent of the total number of patients with malignant neoplasms of the oral cavity. The upper gingiva was most commonly affected. In this series, there were 14 male patients and 6 female patients who ranged in age from 26 to 80 years (average 58 years). The first symptom of melanoma was hyperpigmentation of the mucosa in 10 patients, tumor in 7, and pain in 3 edentulous patients with prostheses. Radical surgery was performed in 13 patients, followed by chemotherapy and radiotherapy in 9 cases. Only 1 patient survived 9 years. The remaining 12 died 11 to 18 months after radical treatment. Palliative therapy was applied in three patients, two patients were treated symptomatically, and two patients refused treatment. Early detection of melanoma is an indication for radical treatment and may increase the survival rate of patients with this disease, which is still very low.     

Clinical and ultrasonographic characteristics of breast metastases from extramammary malignancies

Breast metastases from extramammary malignancies are uncommon, constituting about 2 per cent of all breast tumors. Breast metastasis may be confused with primary benign or malignant neoplasm of the breast. An accurate diagnosis of breast metastasis is important because the treatment and outcome of primary and secondary malignancies of the breast are completely different. The clinical features of 15 patients with breast metastases from extramammary malignancies, excluding lymphoma, between 1982 and 2001 were retrospectively reviewed. There were 2 male and 13 female patients, with ages ranging from 16 to 73 years (median, 48 years). Primary tumors in the 15 cases were 3 hepatocellular carcinomas, 2 gastric carcinomas, 2 malignant melanomas, 1 colon carcinoma, 1 lung adenocarcinoma, 1 ovarian carcinoma, 1 uterine leiomyosarcoma, 1 nasopharyngeal carcinoma, 1 esophageal squamous carcinoma, 1 embryonal rhabodomyosarcoma, and 1 cervical carcinoma. Bilateral breast involvement was observed in two patients. A solitary lesion was evident in 13 patients, with 6 in the right breast and 7 in the left. The interval between diagnosis of primary cancer and the discovery of breast metastasis ranged from 0 to 144 months (median, 12 months). The follow-up period of the primary tumor ranged from 7 months to 156 months (median, 17 months). Breast metastases were associated with disseminated metastatic disease in 14 of the 15 patients. Fourteen of the patients died within a year of breast metastasis diagnosis; median survival was 4 months. Breast metastases from extramammary malignancy are infrequent. Virtually any malignancy can metastasize to the breast. Breast metastasis usually indicates disseminated metastatic disease and a poor prognosis.     

Tumour induction as a consequence of immunosuppression after renal transplantation

Immunosuppressed recipients of organ transplants have a higher incidence of carcinoma than the general population. A retrospective analysis was made at the Department of Urology of Bonn University, investigating 236 renal allograft recipients as to the incidence of neoplasms before and after transplantation. Eleven patients developed malignant tumours after transplantation. In 4 out of these 11 patients, case history showed pre-existing malignancies. Two of the 4 patients developed a second tumour, while the other two had tumour progression (latency period 21–77 months). Three of the 4 patients died of their tumours 21, 42 and 77 months after transplantation, whereas one female patient is still alive and free of neoplasms 32 months after transplantation. In 7 out of these 11 patientsde novo tumours were diagnosed (latency period 3–88 months). All of them are still alive (NED between 15 and 85 months), six of them with good transplant function. There was no difference to be seen in the incidence of malignancies between kidneys supplied by Eurotransplant (n=40) and ABO compatible kidneys from our own donors (n=196). The higher incidence rate of neoplasms in transplant recipients requires high standards in preventive measures. Any suspicious change that may occur in the course of a thorough follow-up of transplant recipients must be removed and examined histologically. Patients with previous malignant diseases must be payed special attention, since they frequently tend to develop another malignant tumour and progression of existing tumours, respectively. As far as immunosuppression is concerned, therapeutic guidelines for the treatment of transplant recipients do not differ from those set up for patients on haemodialysis. Since immunosuppression with increased rates of tumour incidence can also be observed in dialysis patients, the mere fact of increased incidence of neoplasms cannot be taken as an argument against transplantation. With a more or less equal risk of tumour incidence the crucial factor should be the higher quality of life for transplant recipients.     

Malignant lymphoma of the breast: a review of 13 cases.

Thirteen cases of primary malignant lymphoma of the breast are reported from a 15-year retrospective review of records. The ages ranged from 19 to 75 years. One patient had nodular sclerosing Hodgkin's disease and 12 had non-Hodgkin's lymphoma. Eleven patients were treated with local excision, followed by radiotherapy, chemotherapy, or both. One patient had mastectomy and chemotherapy, and one had local excision only. Four patients died 6 months to 7 years after initial diagnosis. One patient was alive and with disease 5 years later. The remainder were alive and free of disease 24 months to 9 years after presentation. Prognosis depended on the clinical stage and histologic grade of the lesion. Five-year survival was 72 per cent, which was slightly better than that observed in mammary carcinoma.