残存尿管に発生した尿路上皮癌

A case of urothelial carcinoma of ureteral stump

症例は70歳，男性。28年前に膀胱癌に対しTURBTの既往あり。1998年に右膿腎症に対し右腎摘除術を施行された。2002年12月近医にて無症候性肉眼的血尿を指摘され当科を受診し，CT，MRIから右残存尿管腫瘍を認めた。右残存尿管摘除術およびリンパ節郭清を施行した。病理組織学的には移行上皮癌，G2，pT2bであった。術後10か月現在再発を認めず，外来通院中である。

A 70-year-old man was found asymptomatic macroscopic hematuria and was referred to our department under the diagnosis of rt-ureteral stump tumor on CT-scan and MRI. He had received partial cystectomy for bladder cancer 28 years before and rt-nephrectomy for pyonephrosis 6 years before. We performed excision of rt-ureteral stump along with the bladder cuff. The histologyical examination revealed grade 2 urothelial carcinoma with muscle invasion. He received no adjuvant chemotherapy. He is now alive and free from recurrence for 10months post-operatively. This is thought to be the 14th case reported in the Japanese literatures.