Nakashima T, Yamaguchi K, Nakajima K, Motoi I, Shimamura M, Hisazumi H, Nakamura Y
Department of Urology, School of Medicine, Kanazawa University.
Hinyokika Kiyo. 1987 Aug;33(8):1248-52.
A 66-year-old female with bilateral ureteral tumors associated with chronic renal failure is presented. She received pan-hysterectomy due to uterine cancer in 1957. She was first referred to our clinic to make internal shunt under a diagnosis of chronic renal failure. In 1979, the diagnosis of neurogenic bladder and bilateral vesicoureteral reflux (rt; grade 3, lt; grade 1) was made. She was admitted to our clinic with complaints of macroscopic hematuria and a temperature of 39 degrees C on April 28, 1983. Cystoscopically, pyuria from the right ureteral orifice was found. Right retrograde pyelography revealed severe dilatation of the right ureter and renal pelvis with some filling defects. For drainage of pus retaining in the right renal pelvis, right percutaneous nephrostomy was made under the guidance of ultrasonography. After her general condition improved, right nephroureterectomy was performed under the diagnosis of right pyonephrosis on June 8, 1983. Right pyelonephritis and right ureteral tumor, grade 3, were pathologically demonstrated. After the operation, an invasive bladder tumor was detected on cystoscopy and ultrasonography, subsequently a total of 3,900 rad irradiation was given to the bladder tumor. She died of pulmonary edema 7 months later. Autopsy demonstrated a transitional carcinoma, grade 3, of the left ureter. Bilateral urothelial tumors of the upper urinary tract is rare, and to our knowledge only 29 cases have been reported in Japan.
本文报告了一位66岁患有双侧输尿管肿瘤并伴有慢性肾衰竭的女性患者。她于1957年因子宫癌接受了全子宫切除术。她最初因慢性肾衰竭诊断被转诊至我院进行内分流手术。1979年，诊断为神经源性膀胱和双侧膀胱输尿管反流（右侧；3级，左侧；1级）。1983年4月28日，她因肉眼血尿和体温39摄氏度的症状入院。膀胱镜检查发现右侧输尿管口有脓尿。右侧逆行肾盂造影显示右侧输尿管和肾盂严重扩张并有一些充盈缺损。为引流右肾盂内潴留的脓液，在超声引导下进行了右侧经皮肾造瘘术。在她的一般状况改善后，于1983年6月8日在诊断为右肾积脓的情况下进行了右肾输尿管切除术。病理证实为右肾盂肾炎和3级右输尿管肿瘤。术后，膀胱镜检查和超声检查发现了浸润性膀胱肿瘤，随后对膀胱肿瘤进行了总共3900拉德的放射治疗。7个月后她死于肺水肿。尸检显示左输尿管有3级移行癌。双侧上尿路尿路上皮肿瘤很少见，据我们所知，日本仅报告了29例。
