膀胱全摘術，回腸利用新膀胱造設術施行後8年で発生した右尿管癌

Right ureteral cancer arising eight years after radical cystectomy and ileal neobladder

　症例は62歳，男性。1998年，膀胱癌の診断にて膀胱全摘術，新膀胱造設術（Hautmann法）を施行した。術後8年目に肉眼的血尿を訴え，CT，経腎瘻的尿管鏡にて右下部尿管に尿路上皮癌，G1の再発を認めた。経尿道的に逆行性尿管腫瘍レーザー焼却術を試みたが困難で，再生検にてG2粘膜固有層への浸潤所見が認められたため，右腎尿管全摘術を施行した。新膀胱造設後の尿管癌の治療法について考察する。

A 62-year-old male underwent radical cystectomy and urinary reconstruction by ileal neobladder according to Hautmann's procedure for bladder cancer in 1998. He presented with macroscopic hematuria eight years after surgery, and computed tomography revealed right lower ureteral tumor. Antegrade ureteroscopic examination and tumor biopsy were performed, and retrograde laser ablation was attempted. However, the retrograde ablation maneuver was too difficult to be completed. Histological examination revealed G2 urothelial carcinoma with invasion of lamina propria. Finally, right nephroureterectomy was performed. We discussed about ureteral tumor recurrence after urinary reconstruction by ileal neobladder.