残存尿管に発生した原発性扁平上皮癌

PRIMARY SQUAMOUS CELL CARCINOMA OF URETERAL STUMP: A CASE REPORT

　症例は63歳の男性。1981年に右尿管結石による膿腎症のため，右腎摘除。1993年2月に結石を自排。8月頃から会陰部不快感が出現し，11月に当科受診。CTにて，膀胱右後面に腫瘤性病変を認めた。試験開放手術によって，右残存尿管腫瘍と判明し，膀胱部分切除，右残存尿管・右精嚢摘除術を施行した。病理診断は，右残存尿管の高分化型扁平上皮癌だった。原発性残存尿管腫瘍は極めて稀で，本邦では自験例が13例目である。

A 63-year-old man, who had undergone right simple nephrectomy for calculous pyonephrosis in 1981, passed a stone in February, 1993, and complained of perineal discomfort in August, 1993. CT scan showed a mass lesion on the right side posterior to the bladder. Explora-tory operation revealed the mass originating from right ureteral stump, involving the right seminal vesicle. The mass was removed en bloc with partial cystectomy. The pathological diagnosis was primary well-differentiated squamous cell carcinoma. Primary tumors of ureteral stumps are very rare, and this is the 13th case report in the Japanese literature.