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症例は79歳,男性。主訴は肉眼的血尿と発熱。画像検査にて,両側性同時性尿管腫瘍と診断した。尿路の閉塞もしくは狭窄により,レノグラム上,両側腎,特に右腎の排泄遅延を認めた。高齢であることや両側性であることを考慮し,腎保存手術を施行した。組織学的には,UC,papillary,G2=G1,pTaと,UC,non-papillary,G3>G2,pT2であった。術後5年が経過したが,再発,転移を認めていない。
A 79-year-old man was referred to our hospital because of macrohematuria and fever. CT scan,and antegrade & retrograde pyelography revealed bilateral ureteral tumors. Left partial ureterectomy and right lower ureterectomy with partial cystectomy were performed. By pathological examination,left ureteral tumor was papillary urothelial carcinoma(UC),G2=G1,pTa,and right ureteral tumor was non-papillary UC,G3>G2,pT2. Postoperative course was uneventful. The patient was closely followed up but no tumor recurrence or metastasis has been noted. Surgical conservative management was discussed in patients with bilateral ureteral tumor especially in advanced age.
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