Takahashi Y, Komeda H, Horie M, Isogai K, Kuriyama M, Ban Y, Kawada Y
Department of Urology, Ogaki Municipal Hospital.
Hinyokika Kiyo. 1988 Jun;34(6):1031-4.
A 50-year-old Japanese male hospitalized with the complaint of fever and pyohematuria. An excretory pyelography revealed the right hydronephroureter due to right ureteral stone. When the ureterolithotomy was carried out, a wide-based and rice-sized tumor co-existed at the site of the epithelium of the ureter lithotomized. Resected tumor was pathologically confirmed as poorly differentiated adenocarcinoma with mitosis. Therefore, total nephroureterectomy with bladder cuff resection was done at 10 days after the first operation. However, malignant cells were not found in the surgical specimen or histologically diagnosed localized glandular ureteritis. He is alive without any evidence of recurrence. It was reported that the glandular metaplasia, a relative rare lesion in the ureter, was correlated with carcinogenesis of adenocarcinoma in urothelium. However, when the lesion is small and localized such as in this case it should be treated with ureterectomy and addition of other suitable adjuvant therapies. Furthermore, endourological techniques which have been recently dramatically progressed may become a weapon against this lesion for both treatment and follow-up.
一名50岁的日本男性因发热和脓性血尿入院。排泄性肾盂造影显示右侧输尿管结石导致右肾积水。在进行输尿管切开取石术时，在切开的输尿管上皮部位同时存在一个基底较宽、米粒大小的肿瘤。切除的肿瘤经病理证实为伴有核分裂象的低分化腺癌。因此，在第一次手术后10天进行了肾输尿管全切除术并切除膀胱袖口状组织。然而，手术标本中未发现恶性细胞，组织学诊断为局限性腺性输尿管炎。他目前存活，无任何复发迹象。据报道，输尿管相对罕见的病变——腺化生与尿路上皮腺癌的发生有关。然而，当病变如本例那样小且局限时，应行输尿管切除术并辅以其他合适的辅助治疗。此外，近年来取得显著进展的腔内泌尿外科技术可能成为治疗和随访该病变的一种手段。
