嚢胞状腫瘤を形成した腎盂移行上皮癌の1例

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75歳男.肉眼的血尿を主訴とする.逆行性腎盂造影で左上腎杯の変形,圧排と腎盂内側に不整な陰影欠損像を認めた.超音波検査,腹部CTで左腎上極に7×5cmの嚢胞状腫瘤を認めた.左腎盂腫瘍,左腎細胞癌を疑い,左腎尿管全摘除術を施行した.組織学的に,嚢胞内腫瘍,腎盂腫瘍とも軽度の細胞異型を認め,移行上皮癌(grade 1)と診断した.術後全身化学療法を行い,退院した.術後19ヵ月を経た現在再発転移を認めていないA 75-year-old man consulted our hospital complaining of gross hematuria. Retrograde pyelography revealed a filling defect and deformity of the upper calix of the left kidney. Abdominal echography and computed tomography revealed a left renal cystic tumor with irregular wall thickness measuring 7 by 5 cm. As left renal pelvic tumor or left renal cell carcinoma was suspected, left total nephroureterectomy was performed. Macroscopically, the cystic tumor contained a papillary tumor connected to the renal pelvis and histopathological diagnosis was grade 1 transitional cell carcinoma. Cystic formation caused by obstruction of the upper calix was suspected. After adjuvant chemotherapy, he has been well without recurrence or metastasis for 19 months after the operation. This is the 15th case of renal pelvic tumors with cystic formation including tumors in the pyelocaliceal diverticulum reported in Japan.