右水腎症による右背部痛が初発症状であった胃癌(Borrmann IV型)の3症例

Abstract

25歳女, 38歳女, 50歳女.右背部痛を初発症状とした胃癌(Borrmann IV型)の3症例を経験した.尿管結石や尿路系の腫瘍を認めないような尿管閉塞症状を呈した場合に, 消化器癌の検索も必要と考えられた

We experienced three cases of right hydronephrosis, which were later diagnosed to have been caused by gastric cancer (Borrmann type IV). The patients were 25-, 38-, and 50-year-old women who complained of right back pain. Ultrasound sonography revealed right hydronephrosis in all three cases. We conducted drip infusion pyelography, computed tomographic scan and retrograde pyelography, but there were no signs of urinary stones or tumors, except for the presence of right ureteral stenosis. Since the patients had upper abdominal discomfort, they underwent gastrofiberscopy, which revealed scirrhous gastric cancer. We suspected that the right ureteral stenosis was caused by metastasis of gastric cancer. After a double J catheter was indwelt at the right ureter, combination chemotherapy of methetrexate + 5-fluorouracil was conducted. The right hydronephrosis diminished and all three patients became catheter-free.