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患者は52歳,女性。3か月前からの頻尿を主訴に来院し,尿細胞診にてclassV,移行上皮癌。血清癌胎児性抗原(CEA)は14.6ng/mlと高値を示し,静脈性尿路造影および逆行性腎盂造影にて両側腎盂腫瘍が疑われた。膀胱鏡にて,膀胱頂部に結節性腫瘍を認め,生検にて,移行上皮癌,G3と診断された。術前に左前腕に動静脈シャントを造設し,両側腎尿管および膀胱摘出術を施行した。病理診断は,両側腎盂および膀胱の移行上皮癌であり,右腎盂腫瘍はCEA-PAP染色陽性であった。
A52-year-old female visited our clinic with a chief complaint of an only frequent urination for three months. The urine cytology revealed class V, T.C.C. and serum CEA was elevated to 14.6 ng/ml. Excretory urography showed the shadow defect in the right renal pelvis and the non-visualized kidney in the left. Retrograde pyelography indicated bilateral renal pelvic tumors. Also, bladder tumor was detected in the dome by cystoscopy. After arteriovenous fistula was made in the left anterior arm for postoperative hemodialysis, bilateral nephroureterectomy and radical cystectomy were performed.
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