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83歳の女性。主訴は不正性器出血。左腎盂腫瘍にて左腎摘出術を施行後,残存尿管に再発し左残存尿管摘出術,以後膀胱内再発にて経尿道的膀胱腫瘍切除術を計5回施行した。不正性器出血が出現し当科を受診し,腟内に多発性乳頭状腫瘍を認め腫瘍切除術を施行したところ移行上皮癌であった。経過から考えて,尿あるいは経尿道的膀胱腫瘍切除術時の灌流液による播種と考えられた。尿路上皮腫瘍の腟内播種は文献上,世界で6例しかなく,自験例が7例目と考えられた。
In 1990 a 83-year-old female presented with a T3, Grade 2 papillary transitional cell carcinoma of the left renal pelvis, which was treated by left nephrectomy. During the following 2 years she underwent a left residual ureterectomy and 5 endoscopic tumor resection for T1b, Grade 2 transitional cell carcinoma of the residual ureter and the bladder. In Aprill 1993 she noticed genital bleeding, and multiple papillary tumor on the vaginal wall were found. Histology of the excised specimens disclosed Grade 2 transititonal cell car-cinoma. We postulate that seeding via urine or the irrigating fluid have occurred.
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