膀胱と両側腎盂に発生した尿道悪性腫瘍の1例

概要

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A 41-year-old male patient underwent transurethral resection for multiple bladder tumors in January, 1979. The pathological examination of the specimen revealed non-invasive transitional cell carcinoma G 2. Thereafter, transurethral coagulation and vesical instillation of various antitumor agents were carried out several times for tumor recurrence during the following eight months. X-ray examination for evaluation of macrohematuria, 15 months following the above treatment, showed left renal pelvic tumor. Left total nephro-ureterectomy was performed in July, 1981. However, microhematuria and class V in urine cytology were continuously observed postoperatively. Right total nephroureterectomy, followed by surgery of the internal shunt, was performed in January, 1982, after diagnosis of renal pelvic tumor by further investigation. Under maintenance hemodialysis, vagotomy and pylorus plastic operation were performed for gastroduodenal bleeding after the above surgery. Total cystectomy and urethrectomy along with irradiation during and after surgery were performed for tumor recurrence in November, 1982 and July, 1983 respectively. Unfortunately, the patient died of multiple liver metastasis and gastro-intestinal bleeding in September, 1983. All the tumor specimens showed the same histological characteristics, i.e., transitional cell carcinoma G 3. Twenty six Japanese cases of epithelial tumors of the bilateral upper urinary tract are reviewed.