経皮的BCG灌流療法が有効であった上部尿路上皮内癌

Succesful Bacillus Calmette-Guerin Perfusion from the Percutaneous Nephrostomy Tube for Carcinoma in situ of the Upper Urinary Tract:A Case Report

　症例は41歳，男性。右腎盂尿管の上皮内癌にて腎尿管全摘除術後，尿細胞診class　Ⅴで，静脈性腎盂造影にて左下部尿管の拡張を認めた。膀胱鏡および尿管鏡では腫瘍性病変を認めなかったが，左尿管尿の細胞診はclass　Ⅴで左上部尿路上皮内癌と考えた。左腎瘻造設後，経皮的BCG灌流療法を行ったところ，尿細胞診は陰性化した。自験例では重篤な副作用はなく，BCG灌流療法は上部尿路上皮内癌に対する有効な治療法となりうると考えられた。

A 41-year old male patient who had a past history of right nephroureterectomy for carcinoma in situ of the renal pelvis and the ureter, showed class Ⅴ urinary cytology and a mild dilatation at the left lower ureter demonstrated by excre-tory pyelography. A random biopsy of the bladder mucosa and the left lower ureter revealed negative findings, how-ever the urinary cytology from the left ureter showed class V. We performed BCG instillation from a percutaneous nephrostomy tube suspecting in situ carcinoma of the left upper urinary tract. The urinary cytology became negative after 1 course of the treatment.