硬性尿管鏡による上部尿路上皮腫瘍の診断の試み

Abstract

上部尿路の陰影欠損の4症例に対し硬性尿管鏡での観察, 生検を試みた.1例は腎盂腫瘍で観察はできたが生検はできず, 2例は上部の尿管腫瘍で生検の結果, 移行上皮癌で腎尿管摘除術を施行し, 1例はlow gradeの下部尿管腫瘍で内視鏡的に焼灼した

We preoperatively diagnosed four cases suspected as malignant urothelial tumor of upper urinary tract using a rigid ureteroscope. In three cases of ureter tumor, biopsy was successful and showed low grade malignancy. Nephroureterectomy was performed in two cases with upper ureteral tumor. The tumor was fulgurated ureteroscopically in a case of lower ureteral tumor. In one case of renal pelvic tumor, biopsy was unsuccessful though the tumor was observed as a papillary configuration. Successively, biopsy using a flexible ureteroscope was performed and the tumor was treated by fulguration. Ureteroscopy is very useful for preoperative diagnosis of ureteral tumor and selection of treatment.