腎結石及び尿管カテーテル留置に合併した移行上皮癌の2例

概要

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Chronic irritation or infection may cause a neoplastic change in the uroepithelium. Our recent experience with two cases of transitional cell carcinoma associated with such stimuli is reported. A 58-year-old woman was found to have a staghorn stone in the left kidney and underwent nephrectomy because of an atrophic kidney. Transitional cell carcinoma was incidentally identified microscopically on the renal pelvis of the removed kidney. Subsequently surgery was elected to remove the residual ureter and the retroperitoneal lymph nodes, both of which turned out to be non-malignant. Then, she was treated by combination chemotherapy with CTX, ADR and CDDP. The second case was a 77-year-old woman who had had a 15-year history of an indwelling ureter catheter after gynecological surgery. Because of purulent discharge without any urine production, she underwent nephrectomy for a contracted kidney. Histology revealed transitional cell carcinoma on the pelviureteral junction. The postoperative courses were uneventful in both cases: they were followed up for 6 months and 9 months respectively without any recurrence of the disease. 90 cases of renal pelvic tumors associated with renal stones were collected from the Japanese literature and reviewed.