Ishibashi Yukari, Yamaguchi Katsuya, Hayashi Yutaro, Onuki Tatsuaki, Suzuki Koutaro
The Department of Urology, Saiseikai Yokohamashi Nanbu Hospital.
Hinyokika Kiyo. 2021 Jul;67(7):313-316. doi: 10.14989/ActaUrolJap_67_7_313.
A 74-year-old woman with gross hematuria for 3 months was referred to our hospital. Contrast-enhanced computed tomographic scan showed a mass on the upper-right renal calyx, and retrograde pyelography showed stenoses from the renal pelvis to the renal calyx infundibulum. We performed an endoscopic biopsy, which led to a diagnosis of urothelial cancer. Therefore, she underwent total right nephroureterectomy, and pathological examination revealed a clear cell variant of invasive urothelial carcinoma. Irradiation was performed mainly on the renal arteriovenous stump 2 months postoperatively; subsequently, three courses of combination chemotherapy comprising gemcitabine plus cisplatin (GC) were administered. Port-site recurrence and pelvic recurrence were observed 22 months after the operation, and GC therapy and pembrolizumab were administered. However she died 36 months after the operation. The clear cell variant of invasive urothelial carcinoma of the upper urethra is rarely reported. Moreover, since this was a very rare case, we have included a literature review in our report.
一名74岁女性,出现肉眼血尿3个月,遂转诊至我院。增强计算机断层扫描显示右肾上极肾盏有一肿块,逆行肾盂造影显示肾盂至肾盏漏斗部狭窄。我们进行了内镜活检,诊断为尿路上皮癌。因此,她接受了右侧全肾输尿管切除术,病理检查显示为浸润性尿路上皮癌的透明细胞变体。术后2个月主要对肾动静脉残端进行了放疗;随后,给予了吉西他滨联合顺铂(GC)的三个疗程的联合化疗。术后22个月观察到切口部位复发和盆腔复发,并给予了GC治疗和帕博利珠单抗治疗。然而,她在术后36个月死亡。上尿道浸润性尿路上皮癌的透明细胞变体很少有报道。此外,由于这是一个非常罕见的病例,我们在报告中纳入了文献综述。