結石による部分的水腎を伴った腎盂扁平上皮癌

Abstract

Squamous cell carcinoma of the renal pelvis is relatively rare, and the presence of calculus has been regarded as important in its pathogenesis. Preoperative diagnosis of the disease is, however, usually quite difficult, and five-years survival has not been reported but one. A 62-year-old woman was admitted with chief complaint of fullness of the left hypochondrial region. Urological examinations revealed a marked hydronephrosis limited to the left upper calyx caused by an impacted stone of thumb-tip size. This hydrocalyx was big enough to displace the stomach to the right side. Filling defect of the middle and lower calyces of affected kidney was also observed. Diagnosis was made as tumor of the renal pelvis associated with hydrocalyx due to stone. Left nephroureterectomy was performed. Metastases to the hilar lymphnodes were obvious. The kidney weighed 1, 350 grams and the tumor was histologically squamous cell carcinoma. During and after the operation, chemotherapy with mitomycin C, 5-FU and endoxan as well as the continuous intraarterial infusion of 5-FU was carried out which seemed to have prolonged the patient's life to some extent. She died in seven month postoperatively.