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Title: 無尿を契機に発見された両側上部尿路膀胱腫瘍の1例
Other Titles: A case of urothelial tumors which occurred simultaneously in bilateral upper urinary tracts and bladder presenting with anuria
Authors: 植村, 元秀  KAKEN_name
井上, 均  KAKEN_name
西村, 健作  KAKEN_name
水谷, 修太郎  KAKEN_name
三好, 進  KAKEN_name
大田, 治幸  KAKEN_name
Author's alias: UEMURA, Motohide
INOUE, Hitoshi
OTA, Haruyuki
Keywords: Simultaneous urothelial tumors of bilateral upper urinary tracts
Bladder tumor
Issue Date: Apr-2001
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 47
Issue: 4
Start page: 269
End page: 271
Abstract: 症例は72歳男で,左腰部痛を自覚し,排泄性腎盂造影で左無機能腎を指摘され経過観察中であったが,無尿を来たして両側水腎症,急性腎不全を疑われた.両側逆行性腎盂造影(RP)及び右double J(DJ)カテーテル留置術を試み,左は下部尿管で閉塞しカテーテルは通過せず,洗浄尿細胞診はクラスIVであった.右は下部尿管で狭窄を認めたが,4.7FrのDJカテーテルは留置可能で,右腎盂尿細胞診はクラスIIであった.CTではRP像に一致して左下部尿管に腫瘤を認めたが,右尿管には認めず,膀胱は全周性に壁が肥厚していた.左尿管鏡で乳頭状腫瘍を認め,膀胱生検では移行上皮癌pTis G3と診断した.左腎尿管摘除術を施行し,左腎盂にも腫瘍を認めた.腎実質組織への浸潤も著明で,尿管においては腹膜浸潤も認めた.術後,狭窄部位に腫瘤像を認め,尿細胞診はクラスIVで,右尿管腫瘍と診断した.肝転移,骨転移,左尿管腫瘍局所再発も認めたが化学療法は拒否され,退院4ヵ月後に癌死した
A 72-year-old male was admitted with a chief complaint of anuria. Clinical examinations showed that he was in uremic state and had bilateral hydronephroses. An endoscopic examination revealed a left ureteral tumor and a bladder tumor. Left nephroureterectomy with partial cystectomy and transurethral resection of the bladder tumor were performed. Pathological examinations showed an invasive left renal pelvic tumor (pT3, G3), an invasive left ureteral tumor (pT4, G3), and a bladder tumor (pTis, G3). Following the operation, roentgenological and urinary cytological findings showed a right ureteral carcinoma. He died of multiple liver and bone metastases and local recurrence at 5 months postoperatively.
PubMed ID: 11411103
Appears in Collections:Vol.47 No.4

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