巨大水腎症に合併した腎盂扁平上皮癌の1例

Abstract

71歳女.約20年前他院にて右水腎症の診断を受け, 穿刺吸引を施行された.腹満感の増強, 食欲不振を主訴に受診し, 右巨大水腎症の診断を受けた.腹部造影CTでは, 20×20×25cm大で正中を超えて広がる右巨大水腎症を認め, 右腎剔除術を施行した.腎盂の広範囲にflast typeの扁平上皮癌を認め, 一部では腎実質に浸潤しており, 病理診断はpT3, G2>G3, INFβであった.本人の希望により術後化学療法は施行せず, 退院となった.術後12ヵ月より血清SCC値上昇, 腹部CTにて多発性肝転移および腹部リンパ節転移を認めたため, 抗癌剤化学療法(M-VAC療法)を施行中である

We report a case of squamous cell carcinoma of renal pelvis associated with giant hydronephrosis. A 71-year-old woman presented to our hospital with a complaint of abdominal fullness due to the right giant hydronephrosis. Although the diagnosis of her hydronephrosis was made about 20 years ago at another hospital, it had been left untreated. Computed tomography showed the right hydronephrosis of 20 x 20 x 25 cm in diameter and no evidence of tumor or calculus in the right urinary tract. For relief of her complaint, right nephrectomy was performed. The fluid content was bloody and 4, 200 ml in volume. Histological examination revealed a flat type squamous cell carcinoma of the renal pelvis. This is the 30th case of renal pelvic malignant tumor associated with giant hydronephrosis reported in Japan. The literature was reviewed and the management of giant hydronephrosis was discussed.