Needle tract implantationした尿管癌の1例

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57歳女.2年前に右尿管癌を発症し摘出術を施行した.そのさい術前に尿管狭窄に対して一時的に右腎瘻を留置した.今回,右腰背部皮下に腫瘤が出現し,尿管癌の転移を疑い腫瘤切除術を施行した.切除標本の病理組織像は尿管癌と酷似しており,腫瘍の部位が2年前の腎瘻穿刺ライン上にあることから尿管癌のneedle tract implantationと診断したMalignant metastasis along the needle tract, called "needle tract implantation" (NTI), has been demonstrated for numerous carcinomas, including prostate, colon and liver. We report a case of NTI of ureteral carcinoma following percutaneous nephrostomy tube replacement. A 57-year-old woman was found to have a subcutaneous mass at the site of nephrostomy. She had a past history of right nephroureterectomy for ureteral carcinoma about one year earlier, and a nephrostomy tube had been inserted before diagnosis postoperatively. We resected the subcutaneous mass. Pathological diagnosis was urothelial carcinoma closely resembling right ureteral carcinoma. To our knowledge, this is the seventh reported case of NTI of upper urinary tract urothelial carcinoma. Percutaneous manipulation carries a potential risk of local tumor spillage and NTI in the nephrostomy tract.
泌尿器科紀要刊行会の論文