自然破裂により発見された乳癌原発転移性尿管腫瘍

A Case of Metastatic Ureteral Tumor

　患者は61歳，女性。自然破裂を来した左尿管狭窄に対し，部分切除術および端々吻合術を施行した。組織学的に尿管壁の腺癌を認めたため，転移性尿管腫瘍と診断した。消化管，肝胆道系，婦人科系を精査したが異常はなく，15年前に切除された乳癌が原発の可能性として考えられた。

A 61-year-old woman with the chief complaint of left flank pain was referred to our hospital. She had a history of left breast cancer excised when she was 46 years old. Under the diagnosis of a left ureteral stenosis which caused spontaneous rupture of a renal pelvis, partial ureterectomy and uretero-ureterostomy were performed. Histopathologi-cal diagnosis was poorly differentiated adenocarcinoma from ureteral muscle layer to periureteral tissue which was thought to be metastatic. Primary lesion was thoroughly investigated but was not delineated, leaving breast cancer as only possible primary origin.