Fukui Sachi, Muraoka Kentaro, Imano Masashi, Takizawa Akitoshi, Murai Tetsuo, Tate Gensyu
The Department of Urology, International Goodwill Hospital.
The Department of Pathology, International Goodwill Hospital.
Hinyokika Kiyo. 2018 Jul;64(7):303-306. doi: 10.14989/ActaUrolJap_64_7_303.
A 62-year-old woman underwent laparoscopic radial nephrectomy for the left renal cell carcinoma in September 2008. In July2016, the patient developed asymptomatic gross hematuria. Computed tomography (CT) revealed the enlargement of the left ureteral stump and an 11mm nodule in the superior lobe of the right lung. Since [F-18] fluoro-D-glucose-positron emission tomography-CT FDG PET-CT demonstrated a lung tumor, we decided to perform right upper lobectomybyvideo-assisted thoracoscopic surgeryin September. The patient was diagnosed with metastatic renal cell carcinoma. We then removed the left ureteral stump and performed partial cystectomy in November. A pathological examination revealed that the tumor was metastatic clear cell renal cell carcinoma invading the muscle layer. Two months later, the patient developed gross hematuria again. Cystoscopy revealed a 1cm tumor around the scar of partial cystectomy. Transurethral resection was performed, and a pathological examination revealed metastatic renal cell carcinoma. We herein report this case of renal cell carcinoma in which recurrence occurred in the ureteral stump, 8 years after radical nephrectomy.
一名62岁女性于2008年9月因左肾细胞癌接受了腹腔镜根治性肾切除术。2016年7月,患者出现无症状肉眼血尿。计算机断层扫描(CT)显示左输尿管残端增粗,右肺上叶有一个11毫米的结节。由于[F-18]氟代脱氧葡萄糖正电子发射断层扫描-CT(FDG PET-CT)显示肺部有肿瘤,我们于9月决定通过电视辅助胸腔镜手术进行右上叶切除术。患者被诊断为转移性肾细胞癌。然后我们在11月切除了左输尿管残端并进行了部分膀胱切除术。病理检查显示肿瘤为转移性透明细胞肾细胞癌,侵犯肌层。两个月后,患者再次出现肉眼血尿。膀胱镜检查发现部分膀胱切除术后瘢痕周围有一个1厘米的肿瘤。进行了经尿道切除术,病理检查显示为转移性肾细胞癌。我们在此报告这例肾细胞癌病例,在根治性肾切除术后8年,输尿管残端出现复发。