放射線治療後に発生したと思われる尿管腫瘍

A CASE OF URETERAL TUMOR FOLLOWING PELVIC IRRADIATION

　子宮癌の放射線治療30年後に発生した尿管腫瘍を経験した．症例は73歳女性，殿部の放射線性皮膚潰瘍の治療中に血尿が出現．尿細胞診陽性，逆行性尿管造影で陰影欠損を腸骨血管交差部付近の尿管に認め尿管腫瘍と診断した．右腎尿管全摘膀胱部分切除術を実施．乳頭状広基性の腫瘍を尿管口より7cm上方に認めた．移行上皮癌grade 2,pT3aであった．本症例は放射線誘発癌として最も確信度の高い診断基準を満たすものであった．

A case of ureter tumor following pelvic irradiation for cervical carcinoma of uterus was reported. She was seventy-three-year-old, and noted macroscopic hematuria during the treatment of radiation dermal ulcer. Ureter tumor was detected with the evidence of positive urine cytology and retrograde ureterography which showed filling defect of contrast medium at the lower part of the ureter. She underwent nephroureter-ectomy with bladder cuff resection. Pathological study showed that the tumor was transitional cell car-cinoma, grade II and pT3a. This case belongs to the most strict criteria of radiation induced tumor.