乳頭状膀胱癌を伴った内反型尿管移行上皮癌の1例

Abstract

85歳女.右側腹部痛と肉眼的血尿を主訴とした.超音波検査では右尿管は全長にわたり拡張し, 下部尿管内に腫瘤を認めた.骨盤CTでも下部尿管内腫瘍が認められたが尿管外への浸潤はなかった.経尿道的膀胱腫瘍切除術を行った後, 右腎尿管全摘, 膀胱部分切除術を施行した.病理組織所見から, 乳頭状膀胱癌を伴った内反型尿管移行上皮癌であったが, 多発した移行上皮癌が異なる増殖形態をとり得ることを示す症例と考えられた

An 85-year-old female was referred to our hospital with chief complaints of right flank pain and gross hematuria. Ultrasonography demonstrated right hydroureteronephrosis and a thumb head-sized solid mass in the lower third of the right ureter. Cystoscopy revealed papillary tumors near the right ureteral orifice. Under the preoperative diagnosis of right ureteral tumor and bladder tumor, transurethral resection of bladder tumor, right nephroureterectomy and partial cystectomy were performed. The gross specimen of the ureter contained a 5 x 3 x 1 cm, polypoid and smooth-surfaced tumor. The pathological diagnosis of the ureteral tumor was transitional cell carcinoma with inverted proliferation, grade 1 >> grade 2. On the other hand, the bladder tumor was papillary transitional cell carcinoma, grade 1. This is a case in which tumor development showed two different types.