Hisamatsu Hiroshi, Yamashita Syuji
The Department of Urology, Kouseikai Hospital, Japan.
Hinyokika Kiyo. 2010 May;56(5):269-72.
We report a rare case of lung cancer with cavitation that was caused by metastasis of urothelial carcinoma. A 73-year-old woman was admitted to our hospital with macrohematuria and general fatigue in September 2003. Computed tomography revealed a left ureter tumor, which was removed by left nephroureterectomy in October 2003. However, a part of the ureter could not be resected because of the adhesion that had occurred after a previous operation. The patient was diagnosed with sigmoid colon cancer, and she underwent sigmoidectomy and resection of the remaining part of the ureter in August 2004. Subsequently, transurethral resection was performed several times for bladder tumor. The pathological diagnosis in February 2005 was pT2. Cisplatin-based intra-arterial chemotherapy was performed because it was not possible to perform a cystectomy due to the poor performance status. In March 2006, computed tomography of the chest revealed a mass shadow with a cavity in the left lower lung field. This was diagnosed as primary or metastatic lung cancer and was treated by left lower lobectomy in November 2006. On the basis of the pathological findings, we diagnosed the mass as metastatic tumor secondary to the urothelial carcinoma. Despite general chemotherapy, the patient's condition deteriorated, and the patient died 1 year later.
我们报告了一例罕见的因尿路上皮癌转移导致空洞形成的肺癌病例。一名73岁女性于2003年9月因肉眼血尿和全身乏力入住我院。计算机断层扫描显示左输尿管肿瘤，于2003年10月行左肾输尿管切除术将其切除。然而，由于先前手术后发生粘连，部分输尿管无法切除。患者被诊断为乙状结肠癌，并于2004年8月接受了乙状结肠切除术及剩余输尿管切除术。随后，因膀胱肿瘤多次行经尿道切除术。2005年2月的病理诊断为pT2。由于患者体能状态较差无法行膀胱切除术，遂行以顺铂为基础的动脉内化疗。2006年3月，胸部计算机断层扫描显示左下肺野有一个伴有空洞的肿块阴影。该病变被诊断为原发性或转移性肺癌，并于2006年11月行左下叶切除术。根据病理结果，我们将该肿块诊断为继发于尿路上皮癌的转移瘤。尽管进行了全身化疗，患者病情仍恶化，1年后死亡。
