多発性肺転移を伴う浸潤性尿路上皮癌の1治験例

Abstract

A 57-year-old woman with advanced urothelial transitional cell carcinoma has achieved complete remission by combination chemotherapy. She visited our clinic for the first time with the complaint of right lower abdominal pain in May, 1981. At bimanual examination, a fist-sized mass was palpated in the right side of the pelvis. A staging work-up examination revealed bilateral pulmonary nodules, swelling of the right iliac lymph nodes and a pelvic tumor invading the bladder and vagina. IVP demonstrated a nonfunctioning right kidney. Histopathology of biopsy specimens taken from the pelvic tumor both transurethrally and transvaginally revealed transitional cell carcinoma. The patient was treated with five courses of combination chemotherapy consisting of cis-platinum, 5-fluorouracil and adriamycin. After four courses of the chemotherapy with which complete disappearance of the pulmonary metastases and marked regression of the pelvic tumor were obtained, she underwent right nephroureterectomy, partial cystectomy, extirpation of the pelvic tumor, and lymphadenectomy. No cancer cell was found, histologically, in the remaining pelvic tumor or the adjunct lymph nodes. However, a few degenerated cancer cells were found in the renal pelvis. She was discharged with no evidence of tumor seven months after the treatment was begun. Further chemotherapy of the same regimen will be given every two months for six months.