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[Urinary complications of Erdheim-Chester disease]
1Service d'Urologie, hôpital Salvator, Marseille.
Insights
Erdheim-Chester disease, a rare histiocytosis, can cause urinary tract obstruction. Minimally invasive endourological treatment with an endoprothesis offers an effective solution, avoiding surgery.
Area of Science:
- Histiocytosis
- Oncology
- Urology
Background:
- Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis.
- Characterized by bone lesions and multiorgan involvement, including orbital, retroperitoneal, and endocrine systems.
Observation:
- A 53-year-old male patient with ECD experienced progressive disease over 11 years.
- Developed extrinsic upper urinary tract obstruction, a rare ECD complication.
- Percutaneous drainage was not feasible, posing a therapeutic challenge.
Findings:
- The patient was successfully treated with an endoprothesis for urine diversion.
- This endourological approach circumvented the need for surgical ureterolysis.
- Demonstrates feasibility of minimally invasive management for urinary complications in ECD.
Implications:
- Highlights endourological interventions as a viable treatment option for urinary tract issues in ECD patients.
- Suggests that minimally invasive techniques can effectively manage complex urological complications associated with rare histiocytoses.
- Emphasizes the importance of considering ECD in patients presenting with unexplained retroperitoneal or urinary tract abnormalities.
Background:
Erdeheim-Chester disease is an uncommon histiocytosis. Fifty-nine cases have been reported in the literature. Bone lesions are usually inaugural followed by multiorgan involvement combining bone disease, orbital infiltration, diabetes insipidis and retroperitoneal infiltration.
Case Report:
A 53-year-old man had Erdheim-Chester disease which progressed over 11 years. The patient developed extrinsic obstruction of the upper urinary tract. This unusual complication of Erdheim-Chester disease raised a difficult therapeutic problem as percutaneous drainage was impossible. The patient was treated with an endoprothesis allowing urine derivation. Surgical ureterolysis was avoided.
Discussion:
Data in the literature favor use of minimally invasive endourological treatment for patients with urinary tract complications of Erdheim-Chester disease.