腎細胞癌の尿管癌の同側同時性発生の1例

Abstract

81歳女.左側腹部痛を主訴とし, 左水腎症, 左腎腫瘍疑いで入院した.腹部CTでは左腎上極に内部不均一で造影される腫瘤と著明な水腎水尿管を認め, MRIでは左腎上極にT2強調像で高信号となる不均一な腫瘤を認めた.左腎盂腫瘍と左尿管腫瘍と診断し, 左腎尿管全摘除術を施行した.病理診断は腎細胞癌(spindle type, grade 3)と尿管の移行上皮癌(grade 2)であった.以上から, 腎細胞癌と尿管移行上皮癌の重複癌と診断した

An 81-year-old woman was admitted to our hospital with left flank pain. Excretory urography revealed left hydronephrosis. Abdominal computed tomography (CT) revealed a large heterogenous tumor in the upper pole and marked hydronephrosis and hydroureter in the lower portion of the left kidney. Left total nephroureterectomy was performed under the diagnosis of renal pelvic and ureter tumor. The pathological diagnosis was of renal cell carcinoma (spindle type, grade 3) in the kidney and transitional cell carcinoma (grade 2) in the ureter. Postoperative chemotherapy was not given. Convalescence was uneventful and fifteen months after the operation she is alive with no recurrence or metastasis.