重複尿管に発生した腎盂尿管腫瘍

A CASE REPORT OF PRIMARY PELVICO-URETERIC CANCER IN THE BIFID URETER

　53歳，女性で不完全重複尿管に発生した腎盂尿管腫瘍の1例を経験した。本例はIP，CTで腎嚢腫が疑われたが，逆行性腎盂撮影で不完全重複尿管が判明，かつ上位尿管の先端が盲端様に描出され，最終的に血管撮影でその盲端様部位に血管新生像が得られたため尿管癌と診断し，腎尿管全摘を施行した。重複尿管合併の尿管癌の報告は本邦で10例みられたが，本例は術前診断が難しく，総合的な放射線診断の重要性を考えさせた1例であつた。

A 53-year-old woman had complaint of recurrent macrohematuria. Left renal cyst was suspected from the findings of excretory urograms and computed tomograms. However, angiograms indicated the neo-vascularity at the blind ending-like area of bifid ureter shown by the retrograde urograms. So under the diagnosis of the ureteral cancer complicated with bifid ureter, left nephroureterectomy was performed. In conclusion, it is essential to diagnose finally ureteral cancer based on proper selection of systematic radiodiagnostic methods.