巨大腎結石に合併した扁平上皮癌の1例

Abstract

Squamous cell carcinoma of the renal pelvis is relatively rare and the coexistence of calculus has been regarded as important in its pathogenesis. A 49-year-old man was hospitalized because of left flank pain. He was pointed out 5×5 cm left renal calculus 3 years ago by a doctor but received no treatment. Physical examination revealed a large palpable mass of a child-head size. Laboratory examinations were not marked except for aseptic pyuria and leukocytosis. Plain film of the abdomen demonstrated a large left renal staghorn calculus. An excretory urogram (IVP) showed a non-functioning left kidney. Diagnosis was made as left renal calculus associated with pyonephrosis and the strong clinical suspect ion of renal tuberculosis. Translumbar left nephrectomy was performed. The kidney was 2500g and the calculus weighed 569g. Microscopically, the epithelium of the renal pelvis consisted of Brunn's nest, squamous metaplasia and squamous cell carcinoma with hyperkeratosis. Pathological diagnosis was squamous cell carcinoma of the renal pelvis with severe non-specific inflammation. The patient was treated with Bleomycin and [60]Co radiation postoperatively for 6 weeks. For three and a half postoperative years, he is alive with quite well condition.