腹腔内出血をきたした原発性尿管扁平上皮癌の1例

Abstract

A case of primary right ureteral squamous cell carcinoma with intraperitoneal invasion was studied. The patient was a 38-year-old male with chief complaints of right lumbago and gross hematuria. He was admitted to our clinic suspected of having calculi. However, the radiogram was negative. As the patient was suffering from severe hypogastric pain, indicating acute abdomen, an investigative celiotomy was performed. The tumor that was subsequently revealed formed a mass engulfing the furcation of the right internal and external iliac arteries, ureter, ileum and sigmoid colon. As a radical resection was considered impossible, as much of the tumor as possible was excised and a colostomy was performed. After the operation, a regimen of polypharmacy, including bleomycin, was administered against the residual tumor. This therapy has proved to be remarkably effective. At present, the patient is under regular medical observation, and the postoperative course has been favorable.