腎癌術後に発生した遺残尿管癌

Ureteral stump tumor after radical nephrectomy for renal cell carcinoma：A case report

症例は85歳男性。腎癌に対し根治的腎摘除術施行後，膀胱癌を認めた。術後BCG膀胱内注入療法を行うも尿細胞診陽性が持続，MRIと尿管鏡検査にて遺残尿管癌と診断し，遺残尿管摘除術を施行した。病理結果は尿路上皮癌，G3，pT2であった。遺残尿管摘除術後，再発を認めたため化学放射線療法を施行し，現在経過観察中である。腎癌術後の遺残尿管から尿路上皮癌が発生したという報告は稀であり，調べ得た限り本邦10例目であった。

Abstract A 85-year-old man followed due to renal cell carcinoma（RCC）for two years after operation was seen microscopic hematuria. Urinary cytology revealed class Ⅴ and bladder tumor was detected on right side of the urinary bladder wall by cystoscopy. The tumor obtained by transurethral resection of the bladder tumor（TURBT）was diagnosed as urotherial carcinoma（pT1,G3）. Thereafter intra-vesical therapy was performed. One year later,ureteral stump tumor was detected on MRI,retrograde pyelography and ureteroscopy. Resection of ureteral stump was performed. Histological diagnosis was urotherial carcinoma（pT2,G3）and surgical margin was positive. The recurrence was detected on cystoscopy as well as by urinary cytology one year later. So chemoradiation therapy was performed. Although ureteral stump tumor after radical nephrectomy for RCC is rare,but the condition should always be in mind.