対側同時発生をみた右腎細胞癌, 尿路上皮癌(左腎盂, 膀胱)の1例

概要

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A 63-year-old man was admitted to our hospital with gross hematuria. Abdominal computed tomography showed an 80mm right renal tumor, 31mm left renal tumor, and 30 mm splenic tumor. Cystoscopy revealed a papillary tumor around the left orifice. Right radical nephrectomy and splenectomy were performed. Histological examination findings showed that the right renal tumor was a renal cell carcinoma, clear cell type, G1, INFα, pT2, ly0, v0, and that the splenic tumor was an arteriovenous fistula. Next, transurethral resection of the bladder tumor was performed and a histological examination showed urothelial carcinoma. Magnetic resonance imaging indicated that the left renal tumor was a renal pelvic cancer. Left total nephroureterectomy and cystectomy were performed, and the histological diagnosis was urothelial carcinoma, G3, pT3, ly1, v2. Followingthe operation, hemodialysis was introduced. It is rare for a renal cell carcinoma and contralateral renal pelvic cancer to occur simultaneously, as only 15 cases includingthe present have been reported in Japan.