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81,男性。回盲部悪性リンパ腫で回盲部切除施行され,約1ヵ月後に右腰痛,発熱が出現。精査の結果,膀胱後部の腫瘍による右下部尿管閉塞,水腎症と診断した。VEPA(Vincristine, Cyclophosphamide, Prednisolone, Adriamycin)療法を行い腫瘍は著明に縮小したが,術後約6ヵ月に小腸膀胱瘻となり,糞尿,発熱を認めるようになったため,小腸切除,膀胱部分切除をおこなった。その後,後腹膜リンパ節に再発し,発症から約8カ月で死亡した。
A 81 year-old male patient, who underwent ileocecal resection for malignant lymphoma about a month previously, was referred to the department of urology for right flank abdominal pain and high fever. ECHO sonography and retrograde pyelography revealed right hydronephrosis with right lower ureteral obstruction. CT showed a retrovesical large tumor. Prior to chemotherapy (VEPA regimen), percutaneous nephrostomy was done. Although the tumor responded well to the chemotherapy, fecaluria was found 5 months later.
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