術後10年目に肺転移をきたした膀胱移行上皮癌

A Case of Lung Metastasis of Bladder Cancer Occurring 10 Years after Radical Cystectomy

　症例は83歳，男性。1988年根治的膀胱摘除術，回腸導管造設術施行。病理診断は移行上皮癌，G2＞G3,pT3b,pNOであった。1997年早期胃癌にて幽門側胃切除術施行。1998年7月，血痰を認め，胸部X線検査，胸部CTにて右下肺野に腫瘤陰影を認めた。原発性肺癌の術前診断で，8月24日右下葉切除術，胸壁合併切除術を施行した。病理診断は移行上皮癌であり，10年前の膀胱癌の肺転移と考えられた。

A 83-year-old male received total cystectomy with ilealconduit construction for bladder cancer in 1988. The his-tological diagnosis was transitional cell carcinoma, G2＞G3, pT3b, pNO. In 1998, he coughed out bloody sputum,then chest X-ray and chest CT revealed a mass lesionin the lower lobe of the right lung. He underwent lowerlobectomy of the right lung. Histopathologically,resected specimen showed recurrence of transitionalcell carcinoma. There has been no sign of further recur-rence and the patient is doing well, as of 26 months post-operatively.