下大静脈後尿管にみられた尿管腫瘍

Duplicated Vena Cava with Right Retrocaval Ureter and Ureteral Tumor:A Case Report

　症例は70歳，男性。主訴は肉眼的血尿。尿細胞診class Ⅴで，排泄性腎孟造影にて右尿管はfishhook shapeを呈した。腹部CTでは第3腰椎のレベルで尿管と下大静脈の交差像を認め，骨盤腔内では約1.5×1.5×2cmのmassを認めた。順行性腎孟造影で，Sカーブを呈した。右下大静脈後尿管に合併した右尿管腫瘍と診断し，右腎尿管全摘出術を施行した。下部尿管に有茎性の乳頭状の腫瘍を認め，組織学的には移行上皮癌grade Ⅱであった。

The patient was a 70 year old male with a chief complaint of macroscopic hematuria. Urinary cytology showed class Ⅴ, and DIP showed "fishhook shape" of the right ureter. CT showed the right ureter running under the vena cava at the level of 3rd lumbar spine, and 15×15×20 mm tumor at the lower portion of the right ureter. The right total nephroureterectomy was performed under the diagnosis of the ureter tumor occurred in right retrocaval ureter.