異時性5重複癌(両側乳癌,胃癌,S状結腸癌,Bowen病,腎盂癌)の1例

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80歳女.右乳癌(41歳時),胃癌(59歳時),S状結腸癌(65歳時),左乳癌(70歳時),左季肋部Bowen病(79歳時)の手術歴があった.今回,肉眼的血尿が出現し,尿細胞診にてPapanicolaou classIV,左腎盂尿細胞診にてPapanicolaou classV,入院時検査で貧血,白血球増多,腎機能低下,CRP上昇を認めた.排泄性尿路造影検査で左腎の造影遅延を,逆行性腎盂造影検査では左腎盂内に不整な陰影欠損を,腹部造影CTでは左上腎杯の拡張とその下方の充実性腎盂腫瘍を認めた.左腎盂腎炎と診断し,左腎尿管全摘術を施行した.病理組織学的所見は,移行上皮癌,G3,pT3,INF-γ,pL1,pV0であり,腎門部リンパ節転移を認めた.術後経過は良好で略治退院となったが,リンパ節転移のため,術後10ヵ月に他院で死亡したWe report a case of five metachronous primary cancers completely resected during 39 years. An 80-year-old woman had been diagnosed with and treated for bilateral breast cancers, gastric cancer, sigmoid colonic cancer, Bowen's disease and renal pelvic cancer. These cancers were found as metachronous cancers and were surgically treated. This is the first case of completely resected metachronous five cancers in Japan.
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