尿管自然破裂を伴った原発性尿管癌の1例

SPONTANEOUS RUPTURE OF THE URETER CAUSED BY PRIMARY URETERAL CANCER

　症例は87歳，女性。左側腹部痛，嘔気，嘔吐を主訴に入院。腹部CTにて左水腎症ならびに上部尿管周囲への尿の溢流を認めた。下腹部CTおよび逆行性腎盂造影にて左下部尿管腫瘍と診断した。術中迅速病理にて断端浸潤を否定したうえで，尿管部分切除術，膀胱尿管新吻合術を施行した。腫瘍の病理組織学的所見は移行上皮癌であった。原発性尿管癌による尿管自然破裂は稀であり，自験例は本邦において2例目と考えられた。若干の文献的考察を加えて報告する。

An 87-year-old woman with chief complaints of left flank pain, nausea and vomiting showed hydronephrosis and periureteral extravasation in left side by abdominal computed tomography. Diagnosis of spontaneous ureter-al rupture due to left ureteral tumor was made by lower abdominal computed tomography and retrograde pyelo-graphy. Partial ureterectomy and uretero-vesico neo-stomy were performed because surgical margin was proved to be free by frozen section. Histopathological examination of the tumor was transitional cell carcinoma, G2＞＞G3, pT2.