膀胱拡大術後に発生した膀胱腺癌

A CASE OF ADENOCARCINOMA OF THE URINARY BLADDER FOLLOWING AUGMENTATION COLOCYSTOPLASTY

　結腸利用膀胱拡大術後23年で発生した膀胱腺癌の1例を報告する。症例は57歳男性で，肉眼的血尿を主訴に来院した。34歳時にS状結腸利用膀胱拡大術，左腎摘除術，右腎部分切除術を受け，44歳時に上行結腸利用膀胱拡大術を再度受けた。慢性腎不全のため3年前より血液透析を受けている。膀胱腺癌の診断で，膀胱全摘術および右腎尿管全摘除術（遊離上行結腸切除も含む）を施行した。病理学的には膀胱部から発生した腺癌であった。

A 57-year-old man with chronic renal failure and hemodialysis since 1990 was admitted complaining of grosshematuria. He had received colocystoplasty using sigmoid colon and left nephrectomy for urinary tuberculo-sis in 1970 and recolocystoplasty using ascending colon in 1980. Total cystectomy and right nephroureterectomy with removal of the isolated segment and ascending colon were performed in 1993. The pathologic diagnosis was well differentiated adenocarcinoma arising from the original bladder, pT₄NxM₀. At present he lives without any evidence of recurrence.