Обструкция мочеточника при раке поджелудочной железы.

Abstract

Introduction. Treatment of patients with pancreatic adenocarcinoma who have metastases in the ureter with subsequent hydroureteronephrosis is extremely rare in clinical practice. Only eight similar cases are on record in the scientific literature. No recent review exists on this topic. This encouraged us to present our review of cases of adenocarcinoma of the pancreas with ureteral metastasis, have been reported earlier. Aim. To systematize the existing knowledge and summarize the clinical experience in the diagnosis and treatment of ureteral obstruction in pancreatic cancer. Materials and methods. The results of the search in the scientific databases PubMed, on the scientific electronic library eLibrary.ru were analyzed for the following keyword queries: «ureter» (ureter), metastasis (metastasis), ureteral metastasis, pancreatic cancer (pancreatic adenocarcinoma), hydronephrosis (hydronephrosis). 59 relevant publications were selected, which were included in the literature review. Results. Metastatic tumors of the ureter are rare and are one of the rarest causes of ureteral obstruction. Most cases of metastatic ureteral cancer are asymptomatic and are a diagnostic finding at autopsy or in the presence of metastatic lesions of other organs. Metastases to the ureters are very rare, but they must be taken into account in the differential diagnosis when a patient with a malignant disease has X-ray signs of ureteral obstruction. The presence of metastases in the ureters may indicate the progression of, for example, pancreatic cancer. Morphological specificity of the ureters, namely: well-developed vascularization of the adventitial membrane and periureteral fiber, contributes to the most frequent primary metastatic lesion of these areas of the ureter. Conclusion. Although the prognosis in these cases is usually unfavorable, but at the same time, an earlier thorough examination followed by organ-specific treatment and resolution of ureteral obstruction can preserve kidney function and increase the chances of survival.