無機能腎となった珊瑚状結石の2例--腎盂扁平上皮癌と膿腎症の鑑別について--

Abstract

Two cases of nonfunctioning staghorn calculus are reported. Case I was a 66-year-old female, who had been found to have left staghorn calculus at another hospital 5 years earlier, but was not operated, On April 6, 1981, she was admitted to our hospital with the chief complaint of left flank pain, The left kidney was not functioning, and nephrectomy was done, Pathological examinations revealed a complication of invasive squamous cell carcinoma of the renal pelvis, Three months later she died of systemic metastasis. Case 2 was a 41-year-old female who had been diagnosed to have left staghorn calculus 9 years earlier but had had the calculus managed conservatively, Five years later the kidney ceased to function, On October 1st, 1981, she was admitted to our hospital with the chief complaint of left flank pain, Nephrectomy was performed and pathological diagnosis was pyonephrosis, Her postoperative course was uneventful The necessity of early removal of staghorn calculi was re-stressed by our experience of these cases, In case I, computed tomography showed irregular density of the renal parenchyma into which the tumor had invaded, a mass growth in the extrarenal pelvis and enlarged retroperitoneal nodes, These findings of squamous cell carcinoma were less characteristic than those of renal cell carcinoma but were enough to distinguish it from pyonephrosis.