Nomura Shunichiro, Nemoto Kaoru, Shioji Go, Miura Takafumi, Tsuboi Narumi, Abe Hiroyuki, Kondo Yukihiro
Nihon Hinyokika Gakkai Zasshi. 2014 Apr;105(2):43-6. doi: 10.5980/jpnjurol.105.43.
A 69-year-old man was admitted with the chief complaint of macroscopic hematuria. Computerized tomography (CT) and ureteroscopy showed right ureter cancer. Right nephroureterectomy and partial cystectomy were performed. Histological examination revealed urothelial carcinoma of ureter (Grade3, pT3, INFbeta, ly1). The patient underwent two courses of adjuvant chemotherapy with gemcitabine and cisplatin. Three months later, abdominal CT showed a mass in his right obturatorius area. The patient's white blood cell count was 34,140 cells/microl. Additionally serum analysis revealed high value of granulocyte colony stimulating factor (G-CSF), 596 pg/ml with no obvious focus. After being diagnosed with recurrent ureteral cancer producing G-CSF, the patient underwent secondary chemotherapy with gemcitabine and docetaxel. After three courses of chemotherapy, CT revealed a marked decrease in tumor size, and the value of G-CSF declined at 31 pg/nl. Subsequently, radiotherapy (60 Gy) was administered. The patient has been alive for 16 months.
一名69岁男性因肉眼血尿为主诉入院。计算机断层扫描（CT）和输尿管镜检查显示右侧输尿管癌。行右侧肾输尿管切除术及部分膀胱切除术。组织学检查显示输尿管尿路上皮癌（3级，pT3，INFβ，ly1）。该患者接受了两疗程吉西他滨和顺铂辅助化疗。三个月后，腹部CT显示右侧闭孔区有一肿块。患者白细胞计数为34140个/微升。此外，血清分析显示粒细胞集落刺激因子（G-CSF）值高，为596 pg/ml，无明显病灶。在被诊断为复发性输尿管癌伴G-CSF产生后，患者接受了吉西他滨和多西他赛的二线化疗。三个疗程化疗后，CT显示肿瘤大小明显减小，G-CSF值降至31 pg/nl。随后给予放疗（60 Gy）。患者已存活16个月。
