腎摘除術後45年を経て発生した残存尿管腫瘍

A case of primary tumor of the ureteral stump 45 years after nephrectomy

　症例は64歳，女性。45年前に左腎結核に対し腎摘除術を受けた。無症候性肉眼的血尿があり，CT，MRIで左残存尿管の拡張を認めたため当科を受診した。左残存尿管摘除術を施行したところ，移行上皮癌を認めた。M-VAC療法を2クール施行し，術後2年3か月経過した現在，再発を認めていない。原発性残存尿管腫瘍とは良性疾患に対する腎摘除術後に残存尿管に腫瘍が発生したものと定義され，本邦では自験例が22例目である。

A 64-year-old woman,with ovarian tumor was referred to our department. She had undergone left simple nephrectomy for renal tuberculosis 45 years ago. She had the history of asymptomatic macroscopic hematuria and her CT scan and MRI showed dilatation of left ureteral stump. We performed ureterectomy followed by chemotherapy（M-VAC）. The pathological diagnosis was transitional cell carcinoma. She is alive with no evidence of disease 27months postoperatively. Primary tumor of the ureteral stump following nephrectomy for benign disease is extremely rare. This is the 22nd case reported in the Japanese literature.