Clinical analysis pulmonary metastasis in 18 cases of transitional cell carcinoma of urinary tract / 解放军医学杂志

ABSTRACT

Objective To investigate the clinical characteristics and treatment method of pulmonary metastasis of transitional cell carcinoma of urinary tract.Methods The clinical data of 18 patients with pulmonary metastasis of transitional cell carcinoma of the urinary tract,who were admitted to the Second Hospital of Tianjin Medical University from July 2005 to March 2009 were analyzed.Results The primary sites of transitional cell carcinoma of these 18 patients were renal pelvis(8 cases),ureter(6 cases) and bladder(4 cases).Multiple metastases to both lungs were found in 14 cases,the chest X-ray showed dense nodular shadows in different size diffused in both lungs,and CT examination revealed the same picture.All the 14 patients were treated with systemic chemotherapy,and 13 of them underwent surgical operation after the discovery of local recurrence in their bladders.Isolated lung metastasis was found in 4 cases,in whom chest X-ray showed isolated dense nodular shadow in the lung,and CT examination revealed soft tissue shadows adjacent to the chest wall.All the 4 patients were treated with implantation of radioactive pellets and systemic chemotherapy,and one of them underwent surgical operation after the discovery of a local recurrence in the bladder.Follow-up was conducted for 6-36 months.Two patients died in 6-12 months,14 died in 12-24 months,and 2 survived for longer than 24 months.Conclusions The incidence of pulmonary metastasis of transitional cell carcinoma of urinary tract is low.Chest radiograph and CT are the main diagnostic means.Systemic chemotherapy should be used as the main treatment for diffuse pulmonary metastasis,radioactive pellet implantation and systemic chemotherapy should be used for a localized isolated pulmonary metastasis,and surgical operation should be done for the patient with local recurrence in the bladder.