尿管内に発症したポリープ状子宮内膜症

Polypoid ureteral endometriosis : A case report

　54歳女性．腹部超音波検査で右の高度水腎症を指摘されて来科．逆行性腎盂造影検査および腹部CT検査にて右尿管の狭窄と尿管内腫瘤を認めたため，右尿管腫瘍の診断にて右腎尿管全摘除術を施行した．尿管病変の病理組織診断結果はポリープ状尿管子宮内膜症であった．本疾患は非常にまれな良性疾患であり，ホルモン補充療法を行っている閉経後の女性で骨盤内臓器にポリープ状病変を認めた場合には，鑑別が必要な疾患と思われた．

Abstract

A 54-year-old woman, who had received bilateral salpingo - oophprectomy and hysterectomy due to ovarian endometriosis at age of 32 and subsequent hormone replacement therapy over 20 years, presented with right hydronephrosis on abdominal ultrasonography. Retrograde pyelogram showed the stenosis of lower ureter as well as ureteral tumor in right ureter. Nephroureterectomy was parformed and histopathological examination revealed polypoid ureteral endometriosis. At present, there is no evidence of recurrence 6 months after the operation. Polypoid ureteral endometriosis is a rare type of endometriosis eventually misunderstood as malignancy. Polypoid ureteral endometriosis should be included in the differential diagnosis of ureteral tumor in the postmenopaused woman with a history of hormone replacement therapy for endometriosis (Rinsho Hinyokika 71 : 85-89, 2017).