原発性尿管腫瘍の1例附統計的観察

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A seventy-six year old man was admitted to the h o spital on Sept. 8, 1958,w ith a chief complaint of painless intermittent hematuria of 4 months' duration. Physical examination revealed essentially negative exc ept for slight benign hypertrophy of the prostate. On urinalysis numerous blood cells and pus cells were found. At Cystoscopy a small blood clot at the right u r eteral orifice was found, from which weak bleeding was seen. An ureteral catheter met an inpassable obstruction 5 cm. up in the right ureter (Fig. 1). On excretory urogram, a right kidney was revealed nonfunctioning, and right hydronephrosis with irregular dilatation and narrowing of the ureter on antegrade pyelogram, which was taken by means of a percutaneous renal puncture (Fig. 2). The punctate was bloody, but no tumor cell was found in it. Suspected diagnosis was (1) renal tumor with ureteral stricture due to carcinomatous infiltration, (2) hydronephrosis and inflammatory stricture of the uretr caused by infected urinary calculus. On Sept. 18, a right nephrectomy with partial ureterectomy was performed. The kidney was firm and slightly enlarged. On the cut surface it appeared to be of chronic pyelonephritis (Fig. 3). Ureter was remarkaffy thickened and firm. The most involved portion at the lower third of the ureter could not be removed, as the patient's condition would not permit. The pathological r eport revealed : (1) transitional cell carcinoma of the upper ureter, (2) chronic right ureteritis, (3) metastatic transitional cell carcinoma of right renal parenchyma and (4) interstitial nephritis (Fig. 4, 5, 6). The postoperative course was almost uneve n tful except continuous hematuria. He was discharged on Nov. 6. The patient died of secondary anemia and of general weakness on Jan. 16, 1959. Ther e have been ninety-one cases of primary benign and malignant tumor of the ureter reported in Japan up to 1958. We have made statistical analysis on these cases. As to the age the majority of cases were found in the sixth and seventh decades (58 per cent). Sixty-nine cases occurred in the male and nineteen cases in the female. Forty-three cases were found in the right ureter, and forty-two cases in the left. The predilection portion was lower third of the ureter (50 per cent). The most common types of tumor were benign papilloma and papillary carcinoma as shown in the table. Hematuria was present in 87 per cent, pain 40 per cent and palpable tumor in 23 per cent.
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菅野英男
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原発性尿管腫瘍の1例附統計的観察

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原発性尿管腫瘍の1例 附統計的観察

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原発性尿管腫瘍の1例附統計的観察