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PubMed1984

[Sonographic diagnosis of channel pelvis].

This paper reports the findings in 22 primigravidae in whom Caesarian section was performed because of impaction of the head in mid-pelvis. 100 women who had normal deliveries served as controls. The routinely-determined external measurements of the pelvis were within the normal range in all women, whereas the distances between symphysis and the 3rd or 5th sacral vertebra were reduced in comparison with the conjugata externa in patients requiring Caesarian section. For an exact diagnosis ultrasound and X-ray pelvimetry was performed post sectionem. A reduced distance between the symphysis and the 3rd or 5th sacral vertebra was ascertained by both methods. Hence, a channel pelvis might be the main reason in these women for standstill in labour. The ultrasound and X-ray pelvimetry results were comparable.

Adult↗

PubMed1982

[Correlation between human kidney shape and kidney pelvis type].

On the basis of a sample consisting of 200 cadavers of both sexes in the age group from 0 to 65 years, a study was performed concerning kidney shape, type of kidney pelvis as well as attempts to correlate the relationship between the 2 kidney traits. In the first phase of analysis of experimental data, attention was paid to the appearance of sex-linked differences, as well as changes arising from the age, seen in the afore mentioned traits. In the second phase, exact statistical analysis was performed to show the relationship of kidney shape with renal pelvis type. The performed analyses indicates that the connection between kidney measurements and renal pelvis type is weak and statistically insignificant.

Adolescent↗

PubMed1982

[Lavage-cytology of the renal pelvis and ureter with special reference to tumors (author's transl)].

On 138 patients with radiologic filling defects in the ureter and renal pelvis lavage cytology was done. With this method it was possible to recognize clearly 39 of 47 urothelial tumors of renal pelvis and ureter (81,3%). Lavage cytology failed in patients with hypernephroma. Severe cellular atypias could be seen in patients with urolithiasis and inflammation. The diagnostic reliability of lavage cytology with urothelial tumors of renal pelvis and ureter is far greater than that of exfoliative urinary cytology and reaches results as good as those from brush biopsy.

Adenocarcinoma↗

PubMed1982

Distant metastasis of urothelial tumors of the renal pelvis and ureter.

Autopsy reports on urothelial tumors of the renal pelvis and ureter in 602 cases were analyzed to investigate the mode of metastasis. Seventy one cases, or 12%, showed no metastasis. Metastasis-free cases occurred with significantly high frequencies in cases of tumors of the ureter and papillomatosis, and less frequently in squamous cell carcinoma cases and in females. Lymph nodes were the most frequent site of dissemination, especially the retroperitoneal and para-aortic lymph nodes. Metastases to the lungs, peritoneum and ipsilateral adrenal were significantly more frequent in cases of tumors of the renal pelvis than in those of tumors of the ureter. Metastases to the retroperitoneal lymph nodes and peritoneum were frequent in cases with metastasis to one organ. Radical nephrectomy with regional lymphadenectomy and/or radiation therapy is indicated for tumors of the renal pelvis. Palliative surgery or nephroureterectomy with a cuff of bladder wall is indicated for tumors of the ureter or papillomatosis, and radical nephroureterectomy with regional lymphadenectomy and/or radiation therapy in cases where a pronounced tendency of down-growth invasion is suspected.

Adenocarcinoma↗

PubMed1982

The musculature of the human renal calices, pelvis and upper ureter.

The musculature of the proximal part of the human upper urinary tract has been examined using light and electron microscopy. Two morphologically and histochemically distinct types of smooth muscle cell have been identified within the walls of the renal calices and pelvis. One type is rich in non-specific cholinesterase and appears identical in fine structure to the smooth muscle of the ureter. The second type is devoid of non-specific cholinesterase and possesses a number of unusual fine structural features. Cells of the latter type form a thin sheet of caliceal muscle which extends across the renal parenchyma to interconnect with adjacent minor calices. Similar cells extend away from the renal substance to form a discrete layer confined to the inner aspect of the muscle coat, the remainder of which consists of 'typical' smooth muscle cells arranged into compact bundles. The inner layer of 'atypical' cells is present in the walls of the major calices and pelvis but ceases in the pelvi-ureteric region. It is proposed that these 'atypical' cells are capable of spontaneous contractility and perform a pacemaker function which is responsible for the initiation of ureteric peristalsis.

Cholinesterases↗

PubMed1994

Magnetic resonance imaging techniques in the pelvis.

Basic and more recent advances in imaging the pelvis are reviewed in this article. Commercially available innovations such as phased array multicoils in fast spin echo imaging can be used to improve resolution for MR imaging of the pelvis. Chemical shift imaging and vascular imaging in the pelvis also are reviewed, and potential roles for gadolinium-enhanced imaging and gastrointestinal contrast agents are discussed.

Blood Vessels↗

PubMed1994

Primary carcinoid of the renal pelvis.

We report a case of a surgically resected carcinoid of the renal pelvis diagnosed as papillary transitional cell carcinoma by light microscopy. Immunocytochemistry studies identified three immunoreactive products: cytokeratin, S-100 protein, and neuron-specific enolase. Ultrastructurally, dense core granules were seen. The histogenesis of renal pelvis carcinoid has not been clarified. This is the first documented case of a renal pelvis carcinoid.

Adult↗

PubMed1994

[2-axial conformational irradiation for whole-pelvis irradiation of cervical cancer: improvement and evaluation with DVH].

Whole-pelvis irradiation with the two-axial conformation technique has been performed in cervical cancer since 1976. In 1990 this technique was improved by obtaining target areas from serial CT images instead of axial transverse tomograms. The aim of this study was to show the advantage of the new two-axial conformation technique compared with the old type of conformation technique, and also with conventional techniques using DVH of normal tissues. The uniformity of dose within the high dose-region and fit to the target areas observed in the new type were better than those in the old type. This improved result was most remarkable in rectal DVH. The new two-axial conformation technique was also compared with the two-opposed technique and box technique. With the new type, cumulative irradiated volume in rectum of more than 40 Gy was reduced to 37% of that with the two-opposed technique. In bladder and intestine, the smallest volume irradiated to more than 40 Gy was observed using the new two-axial conformation technique. With these results, we conclude that the new two-axial conformation technique for whole-pelvis irradiation is suitable to conform the high dose region with the target region in the pelvis, and at the same time to protect the surrounding normal tissues.

Female↗

PubMedDate not supplied

[Primary tumors of the kidney pelvis].

Of 507 patients with renal tumours 36 (7.1%) presented with primary epithelial neoplasms of the renal pelvis. Histological investigation revealed benign papillomas in 3 (8.3%) cases. These patients underwent resection of the renal pelvis along with the tumour. Nephro-ureterectomy was performed in 33 patients, of whom 27 (75%) had it for transitional cell carcinoma, 5 (14%) for squamous cell carcinoma and 1 (2.7%) patient for solid carcinoma of the pelvis. Results of surgical treatment vary with the process stage so that the more advanced the stage, the poorer is the prognosis. High efficiency was shown of nephro-ureterectomy. At 5 years 9 of 13 operated on are alive without signs of metastatic disease.

Carcinoma, Squamous Cell↗

PubMed1995

[Fast and ultra-fast sequences in MRI of the pelvis and retroperitoneum].

Fast and ultrafast sequences are crucial prerequisite for optimum diagnostic impact in magnetic resonance (MR) imaging of the pelvis and retroperitoneum. In MR imaging of the pelvis, heavily T2-weighted fast turbo spin echo (TSE) sequences with acquisition times of 2-4 min have widely replaced time-consuming conventional T2-weighted SE sequences due to substantial time savings and better image quality. Fast and ultrafast gradient recalled echo (GRE) sequences are the basis of dynamic contrast-enhanced studies. In MR imaging of the retroperitoneum, fast and ultrafast sequences currently play the most important role as they allow for breath-hold acquisition of a sufficient number of images free of motion artifacts. The current roles of TSE, tubo gradient spin echo (TGSE), GRE and echoplanar imaging (EPI) sequences in MR imaging of the pelvis and retroperitoneum is discussed.

Artifacts↗

PubMed1977

Excretion in mammals: role of the renal pelvis in the modification of the urinary concentration and composition.

The mammalian renal pelvis has previously been regarded as having no physiological function other than that of a receptacle for the urine before it moves through the ureter. It has long been known that the renal pelvis in mammals shows elaborate extensions that bring the urine in intimate contact with outer and inner medullary tissue. The epithelium covering these areas is of a type that indicates that transport of solutes and water can take place across it. Physiological studies have shown that urea and water readily move across the renal papillary epithelium. The pronounced ability of ruminants to conserve urea when placed on a low protein diet coincides with a highly developed renal pelvis with specialized fornices and secondary pouches. It is suggested that urea conservation in low protein animals takes place partly in the renal pelvic extensions where urea is returned to the blood. A hypothesis is also proposed for the concentrating mechanism in which recycling of urea from the pelvic urine across the papillary epithelium plays an important role.

Animals↗

PubMed1997

[A case of transitional cell carcinoma of renal pelvis with extremely high serum levels of CA19-9 and CEA].

We report a case of transitional cell carcinoma of the renal pelvis with extremely high serum levels of carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA). A 69-year-old woman was admitted with gross hematuria. Imaging diagnosis revealed a tumor in the left renal pelvis and multiple liver and bone metastases. Serum levels of CA19-9 and CEA were 2,557 U/ml (normal < 36) and 523 ng/ml (normal < 3.8), respectively. She died of cancer progression 3 weeks after admission. An autopsy diagnosis was transitional cell carcinoma of the left renal pelvis. No abnormal findings were recognized in the gastrointestinal organs. Cancer cells showed a positive immunohistochemical staining for both CA19-9 and CEA.

Aged↗

PubMed1997

[A clinicopathological study on carcinoma of the renal pelvis and ureter].

We investigated the clinicopathological features of 62 patients with transitional cell carcinoma of the renal pelvis and ureter. Four patients had been treated for bladder cancer. Among 58 patients without precedent bladder cancer, 6 had coexistent bladder cancer and bladder cancer subsequently developed in 13. The 5-year cause-specific survival rate was 33% in cases with coexistent bladder cancer, 75% in those with subsequent bladder cancer and 62% in patients without association of bladder cancer. Distant metastases were found in 23 of 62 (37%) cases, the most frequent site being lymph nodes. The site of the primary tumor (renal pelvis and/or ureter) and the pathological findings such as grade, stage, type of infiltration, venous and lymphatic invasion, were significantly correlated to cause-specific survival. Multivariate analysis showed the most influential factors to be the type of infiltration and the site of the primary tumor. Therefore, patients with INF beta or gamma tumors both in the renal pelvis and ureter had a poor prognosis. However, association of bladder cancer was not related to survival.

Adult↗

PubMed1998

[Pyelocaliceal urothelial carcinoma associated with pelvis lithiasis].

OBJECTIVE: Epithelial neoplasms of the upper collecting system account for less than 5 percent of all urothelial tumors and they are not histologically unlike those of the bladder. We report a case of pelviocaliceal urothelial carcinoma associated with a calculus in the renal pelvis. METHODS: A 75-year-old man who presented with hematuria, fever and flank pain is described. The US and CT findings disclosed a calculus in the left renal pelvis and hydronephrosis nephrectomy was performed. RESULTS: The pathological analysis revealed a pelviocaliceal urothelial carcinoma on an underlying stone and overexpression of the p53 protein. CONCLUSION: Diagnostic imaging techniques may fail to detect tumors of the renal pelvis with a large underlying stone. The overexpression of the p53 protein may be involved in the malignant transformation of the urothelial cells.

Aged↗

PubMed1998

[A case of renal pelvic carcinoma in a completely duplicated pelvis and ureter].

We report a case of renal pelvic carcinoma with a completely duplicated pelvis and ureter. A 72-year-old man was referred to our hospital because of asymptomatic and macroscopic hematuria. Excretory urography and retrograde pyelography revealed a tumor in the left upper renal unit of a completely duplicated pelvis and ureter. Left total nephroureterectomy was performed. Histological diagnosis was transitional cell carcinoma. This is the 8th case of upper urotherial tumor occurring in a completely duplicated pelvis and ureter in the Japanese literature.

Aged↗

PubMed1996

Chondrosarcoma of the pelvis. Prognostic factors for 67 patients treated with definitive surgery.

BACKGROUND: Chondrosarcoma (CS) most commonly involves the pelvis. Local and systemic failures often result in poor outcome. Prognostic factors that determine patient outcome remain ill-defined. METHODS: We retrospectively analyzed 67 patients with CS of the pelvis treated by definitive surgery from January 1970 to December 1992. All patients had localized disease including Grade 1 (19 patients), Grade 2 (18 patients), Grade 3 (17 patients), and dedifferentiated (13 patients) tumors. Thirty-two patients underwent a limb-sparing surgical resection and 35 patients underwent hemipelvectomy. Follow-up was available for all patients. The median duration of follow-up for the survivors was 115 months (range, 24-288 months). RESULTS: At last follow-up, 52% of the patients were disease free, 8% were alive with disease, 36% died of disease, and 4% died of other causes. Nineteen patients (28%) had developed a local recurrence (LR). The median time to LR was 23 months (range, 1-111 months). Independent variables in a multivariate analysis associated with increased risk of LR included inadequate surgical margin, tumor epicenter in the pubis, and high grade histology. LR did not influence overall patient survival. Twenty-three patients (36%) developed distant metastases at a median time of 9 months (range, 1-111 months) postoperatively. Metastases developed in 0% of the patients with Grade 1, 20% of the patients with Grade 2 60% of the patients with Grade 3 and 75% of patients with dedifferentiated CS. On multivariate analysis, histologic high grade was the only significant predictive variable for distant relapse (P = 0.005). CONCLUSIONS: The critical issue for a favorable outcome in low grade CS of the pelvis is adequate surgical excision (i.e., negative surgical margin). The high rate of systemic failure in high grade and dedifferentiated CS, despite adequate surgery, emphasizes the need for more effective systemic therapy.

Adult↗

PubMed1983

Mapping of urothelium in carcinomas of the renal pelvis and ureter. A report of nine cases.

Complete histologic mapping of the urothelium was performed in nine surgical nephroureterectomy specimens. In seven patients, the primary lesion was carcinoma of the renal pelvis; in two, carcinoma of the ureter. In all cases, in areas peripheral to obvious carcinomas, there were extensive epithelial abnormalities akin to those previously described in mapping studies of the urinary bladder. The epithelial changes ranged from hyperplasia to flat carcinoma in situ. The latter was observed in four patients and appears to be an unfavorable prognostic sign: one of the four patients died of disease three months after surgery, and two patients developed metachronous carcinomas of the urinary bladder. Only one of these four patients has been free of disease for 21 months. One additional patient with atypical urothelium in the renal pelvis also developed a metachronous bladder cancer. Significant neoplastic abnormalities of the epithelium of the collecting ducts were observed in six of the seven cases of carcinoma of the renal pelvis. The study emphasizes the essential unity of the urothelium as a target organ for neoplastic events.

Aged↗

PubMed1995

Surgical indications for Ewing's sarcoma of the pelvis.

BACKGROUND: Despite advances in adjuvant therapy, Ewing's sarcoma of the pelvis remains an anatomic site with a poor prognosis. This study evaluate the role of surgery in the management of patients with pelvic Ewing's sarcoma who also received conventional radiation therapy and chemotherapy. METHODS: From May 1978 to February 1994, 19 patients with Stage IIB Ewing's sarcoma of the pelvis were treated at the UCLA Medical Center (Los Angeles, CA). There were eight lesions of the ilium, two of the sacrum, and nine involving two adjoining regions of pelvis. All patients received conventional medical management. The 19 patients were divided into two groups according to treatment modality. A group of 12 patients (Group A) had surgical resection, and their results were compared with those of another group of 7 patients (Group B) who did not have surgery. RESULTS: The 5-year cumulative survival (Kaplan-Meier method) was 39% for all patients, 51% for Group A, and 18% for Group B. The 3-year cumulative survival was 59% for all patients, 72% for Group A, and 36% for Group B. Although the survival rate of Group A seemed better than that of Group B, the difference was not statistically significant (P = 0.093, log rank method). This study also suggested that, regardless of treatment modality, the outcome of patients with lesions involving two adjoining pelvic bones was poorer than that of those with a single lesion. In Group A, the 3-year cumulative survival rate for patients with single bone lesions (n = 8) was 86% and for patients with lesions involving two adjoining pelvic bones (n = 4) was 50% (P = 0.045, log rank method). Furthermore, the statistical analysis of the combined data of the single pelvic bone lesions in UCLA and that of Mayo Clinic series (n = 16 for surgery group and n = 15 for nonsurgery group) confirmed the better results for the surgical patients, which was consistent with the results from the Mayo Clinic with an even greater significance (P < 0.002). CONCLUSION: This study demonstrates that surgery plus chemotherapy and radiation therapy is helpful for treating patients with pelvic Ewing's sarcoma so long as the tumor is limited to a single pelvic bone.

Adolescent↗