腎盂の移行上皮性腫瘍の6例

Abstract

Four cases of transitional cell carcinoma and two cases of transitional cell papilloma are reported. Among them the first and third cases were observed for a long time and took interesting courses respectively. The first case, a man aged 48, was observed for 12 years and 7 months. In this case the tumor was noticed in the right pelvis and right nephrectomy was done at the age of 35. Then the tumor invaded down to the right ureter and the bladder, and right ureterectomy and total cystectomy with left cutaneous ureterostomy were performed at the age of 47 (Fig. 3, 4). At the age of 48 the tumor was noticed in the penile urethra and metastasized to both deep inguinal lymphnodes. This tumor of the urethra was treated with total exstirpation of the penis (Fig. 7) and both inguinal lymphadenectomy. These tumors of the right pelvis, the right ureter and the bladder were histologically all papillary transitional cell carcinoma (Fig. 5, 6). On the other hand the tumor of the urethra was histologically transitional cell papilloma, but its inguinal metastases were transitional cell carcinoma. The third case, a woman aged 53, was observed for 7 years and 6 months. In this case the tumor began to grow in the right pelvis at the age of 46 and right nephrectomy was done. This tumor was histologically transitIonal cell papilloma. At the age of 48 the tumor spread down to the right ureter and even to the bladder and right ureterectomy and trasurethral electrocoagulation (EC) were done. The tumor of the bladder which was histologically transitional cell papilloma recurred at the age of 49. As the treatment, transurethral EC was repeated about 60 times for 2 years and 9 months. This EC brought about good effect in the early period of the treatment, but in the later period gave almost no effect and so total cystectomy with left cutaneous ureterostomy was performed at the age of 52 (Fig. 14). This tumor of the bladder was papillary transitional cell carcinoma histologically. After total cystectomy this tumor invaded the formx of the vagina and meanwhile metastasized to the right ovary and lymphnodes. At the age of 53 C060 irradiation to the tumor of the vagina had considerably good effect and right ovariectomy was performed (Fig. 17, 18, 19). As previously reported in many publications, the malignant changes of the transitional cell papilloma to papillary transitional cell carcinoma were observed in these 2 cases.