RESUMO
A 41-year-old female who suffered local recurrence of cervical cancer after receiving chemoradiotherapy underwent radical hysterectomy, radical vaginal resection, and pelvic and paraaortic lymph node dissection. After surgery, bilateral hydronephrosis due to right ureteral stenosis and left uretero-vaginal fistula occurred. We therefore placed a bilateral ureteral stent. Thereafter, we continued to replace the bilateral ureteral stent once every 3 months, but the replacement of the right ureteral stent became impossible three years after the initial placement. We thus performed bilateral upper urinary tract reconstruction using an ileal ureter with the aim of both eliminating the left ureteral vaginal fistula and resolving the right ureteral stricture.
Assuntos
Hidronefrose , Ureter , Obstrução Ureteral , Adulto , Constrição Patológica , Feminino , Humanos , Íleo , Ureter/cirurgia , Obstrução Ureteral/etiologia , Obstrução Ureteral/cirurgiaRESUMO
We present a case in a 74-year-old female patient whose initial symptom was right flank pain. Enhanced computed tomography showed a mass (about 15×12 cm) in the retroperitoneum, inferior vena cava tumor thrombus (Level III: Neves and Zincke system) and liver metastasis. The primary tumor exploded and inferior vena cava tumor thrombus caused congestive liver one and a half month later. Preoperative diagnosis was right adrenocortical carcinoma (cT4N0M1 stage IV). We performed complete resection of tumor including metastasis. Pathological findings on the resected specimen revealed pleomorphic leiomyosarcoma, which was discontinuous tumor from the right normal adrenal grand. There was no evidence of local recurrence or metastasis after 6 months with no additional treatment.