原発性腎盂尿管腺癌について

Abstract

A case of primary mucinous adenocarcinoma of the renal pelvis and ureter was presented. The patient was a 30-year-old man who had persistent fever and pyuria for past several months. Preoperative intravenous pyelogram revealed nonfunctioning left kidney without stone, and retrograde pyelography was impossible because of ureteral obstruction on that side. Total nephroureterectomy was performed, and pathological diagnosis was made as pelvic and ureteral mucinous adenocarcinoma. Postoperative course was uneventful. Twenty-two previously reported cases were briefly reviewed. The pathogenesis of this tumor seems to be closely related to longstanding chronic pyeloureteritis usually associated with calculi. This columnar cell metaplasia may occur directly from the transitional epithelial cells. As a choice of surgical treatment, total nephroureterectomy is recommended, because this tumor is considered to have a tendency of multiple occurrence in the renal pelvis and ureter.