左腎盂癌と右腎細胞癌の同時発生重複癌の1例

A case of simultaneous double cancer；left renal pelvic carcinoma and right renal cell carcinoma

　63歳，男性。肉眼的血尿を生じ，精査の結果，左腎盂癌および右腎細胞癌の重複癌と診断された。最初に左腎尿管全摘除，膀胱部分切除術が施行され，2か月後に右腎部分切除術が施行された。病理組織学的所見は，左腎盂癌が移行上皮癌（G2＞G3）＞扁平上皮癌でpT1，右腎細胞癌が淡明細胞癌（G2）でpT1aであった。一側腎盂尿管癌，対側腎細胞癌の同時発生重複癌の報告例は少なく，検索しえた範囲内で本邦10例目である。

A 63-year-old man with gross hematuria was revealed left non-visualized kidney by IVP. Abdominal CT scan showed left renal pelvic tumor with hydronephrosis and right renal tumor. Retrograde pyelography demonstrated filling defects at the left renal pelvis,and washing cytology of left urinary tract was class Ⅳ. Under the diagnosis of left renal pelvic carcinoma and right renal cell carcinoma simultaneously occurred,left nephroureterectomy with bladder cuff resection was performed,followed by right partial nephrectomy 2months later. The pathological diagnosis was urothelial carcinoma and renal cell carcinoma. Simultaneously occurred renal pelvic tumor and contralateral renal cell carcinoma is rare,only 10 cases having been reported in Japanese literature including the present case.（Rinsho Hinyokika 60：493-495,2006）