Soda Tetsuji, Nishimura Kenji, Kobayashi Yasuyuki, Kato Taigo, Tokugawa Shigeki, Kishikawa Hidefumi, Ihara Hideari, Ichikawa Yasuji
Department of Urology, Hyogo prefectural Nishinomiya Hospital.
Hinyokika Kiyo. 2009 Aug;55(8):491-4.
A 63-year-old man was admitted to our hospital with gross hematuria. Abdominal computed tomography showed an 80mm right renal tumor, 31mm left renal tumor, and 30 mm splenic tumor. Cystoscopy revealed a papillary tumor around the left orifice. Right radical nephrectomy and splenectomy were performed. Histological examination findings showed that the right renal tumor was a renal cell carcinoma, clear cell type, G1, INFalpha, pT2, ly0, v0, and that the splenic tumor was an arteriovenous fistula. Next, transurethral resection of the bladder tumor was performed and a histological examination showed urothelial carcinoma. Magnetic resonance imaging indicated that the left renal tumor was a renal pelvic cancer. Left total nephroureterectomy and cystectomy were performed, and the histological diagnosis was urothelial carcinoma, G3, pT3, ly1, v2. Following the operation, hemodialysis was introduced. It is rare for a renal cell carcinoma and contralateral renal pelvic cancer to occur simultaneously, as only 15 cases including the present have been reported in Japan.
一名63岁男性因肉眼血尿入院。腹部计算机断层扫描显示右肾肿瘤80mm，左肾肿瘤31mm，脾肿瘤30mm。膀胱镜检查发现左侧尿道口周围有乳头状肿瘤。行右根治性肾切除术和脾切除术。组织学检查结果显示，右肾肿瘤为肾细胞癌，透明细胞型，G1，INFα，pT2，ly0，v0，脾肿瘤为动静脉瘘。接下来，行经尿道膀胱肿瘤切除术，组织学检查显示为尿路上皮癌。磁共振成像表明左肾肿瘤为肾盂癌。行左全肾输尿管切除术和膀胱切除术，组织学诊断为尿路上皮癌，G3，pT3，ly1，v2。术后开始进行血液透析。肾细胞癌和对侧肾盂癌同时发生的情况很少见，在日本仅报道了包括本病例在内的15例。
