腎摘後膀胱転移を来した腎細胞癌

Metastasis to urinary bladder of renal cell carcinoma after radical nephrectomy : A case report

　80歳男性．腎癌肺転移に対し，インタフェロンα製剤による免疫療法中に脳梗塞を発症し，全身検索中のCTにて膀胱腫瘍が判明した．膀胱鏡では右尿管口背側の後壁に孤立性非乳頭状腫瘍を認めた．経尿道的膀胱腫瘍を施行し，病理組織検査では腎細胞癌膀胱転移と診断された．本症例では尿流性に膀胱粘膜に播種したものと考えた．

Abstract

We report a rare case that resulted in metachronous metastasis of clear cell renal cell carcinoma (RCC) to the urinary bladder after radical nephrectomy. In 80 years old male developing cerebral infarction during INF-α immunotherapy for multiple pulmonary metastase two years and eight months after right radical nephrectomy, a bladder tumor was incidentally detected by computed tomography. Cystscopy revealed a solitary, non- papillary tumor on the posterior wall at the dorsal side of right ureteral orifice. Transurethral resection of the bladder tumor was done and the pathological examination revealed bladder metastasis of RCC. We speculated that this bladder metastasis was due to malignant cells moving along the urinary tract and getting implanted on the bladder epithelium (Rinsho Hinyokika 72 : 1027-1030, 2018).