腎自然破裂をきたした腎盂尿管癌の2例

Abstract

53歳と57歳男の腎破裂を報告した.1例は腎被膜外破裂, 1例は腎皮膜内破裂であった.2例とも基礎疾患は移行上皮癌, pT2, grade 2の腎盂尿管癌であった

Two cases of spontaneous rupture of the renal parenchyma caused by the renal pelvic and the ureteral cancer are reported. Case 1 was in a 53-year-old male who had left flank pain 2 weeks before admission to the hospital. In retrograde pyelography, the left upper ureter was visualized irregularly, but the left pelvis was not visualized. Computed tomography (CT) and magnetic resonance imaging (MRI) showed perirenal hematoma. Left nephroureterectomy with bladder cuff was performed under diagnosis of left renal pelvic and ureteral cancer. The rupture of the left renal parenchyma with extracapsular hematoma was identified. Pathological diagnosis was transitional cell carcinoma, grade 2 and pT1 of the left renal pelvis and the left ureter. Case 2 was in a 57-year-old male who had left flank pain 2 hours after he had enhanced CT study. MRI showed the left pelvic and the ureteral cancer with perirenal hematoma after 4 days. Left nephrourererctomy and partial cystectomy were performed. The rupture of the renal parenchyma with subcapsular hematoma was identified. Pathological diagnosis was transitional cell carcinoma, grade 2 and pT1 of the left renal pelvis and the left ureter.