巨大水腎症に発生した腎盂扁平上皮癌

RENAL PELVIC CANCER ASSOCIATED WITH GIANT HYDRONEPHROSIS: A CASE REPORT

　症例は62歳，男性。1990年，肉眼的血尿を主訴に当科受診。左腎盂尿管移行部狭窄症に伴う左巨大水腎症と診断し，手術を勧めるも拒否。その後通院せず。1996年3月，肉眼的血尿が頻回となり再受診。CTにて左腎盂に広範に拡がる腫瘍を認め，左腎尿管全摘術を施行。病理診断は腎盂扁平上皮癌であった。巨大水腎症に発生した腎盂癌は稀であり，自験例は本邦26例目と思われた。

A 62-year-old man with a 6-year history of hydrone-phrosis presented to our hospital with a chief complaint of gross hematuria. Ultrasound and abdominal CT scan showed large hydronephrosis which had been replaced completely with solid tumor mass. Urine cytology revealed squamous cell carcinoma. In April 1996, ne-phroureterectomy was performed and the histological diagnosis was squamous cell carcinoma of the renal pelvis combined with transitional cell carcinoma, pT4, pNO.