Numasato S, Seino K, Handa K, Sakuma Y, Obara N
Hinyokika Kiyo. 1984 Dec;30(12):1827-33.
A 41-year-old male patient underwent transurethral resection for multiple bladder tumors in January, 1979. The pathological examination of the specimen revealed non-invasive transitional cell carcinoma G 2. Thereafter, transurethral coagulation and vesical instillation of various antitumor agents were carried out several times for tumor recurrence during the following eight months. X-ray examination for evaluation of macrohematuria, 15 months following the above treatment, showed left renal pelvic tumor. Left total nephro-ureterectomy was performed in July, 1981. However, microhematuria and class V in urine cytology were continuously observed postoperatively. Right total nephroureterectomy, followed by surgery of the internal shunt, was performed in January, 1982, after diagnosis of renal pelvic tumor by further investigation. Under maintenance hemodialysis, vagotomy and pylorus plastic operation were performed for gastroduodenal bleeding after the above surgery. Total cystectomy and urethrectomy along with irradiation during and after surgery were performed for tumor recurrence in November, 1982 and July, 1983 respectively. Unfortunately, the patient died of multiple liver metastasis and gastro-intestinal bleeding in September, 1983. All the tumor specimens showed the same histological characteristics, i.e., transitional cell carcinoma G 3. Twenty six Japanese cases of epithelial tumors of the bilateral upper urinary tract are reviewed.
一名41岁男性患者于1979年1月因多发性膀胱肿瘤接受经尿道切除术。标本的病理检查显示为非浸润性移行细胞癌G2级。此后，在接下来的八个月中，因肿瘤复发多次进行经尿道凝固术及膀胱内灌注各种抗肿瘤药物。上述治疗15个月后，为评估肉眼血尿进行X线检查，显示左肾盂肿瘤。1981年7月行左肾输尿管全切术。然而，术后持续观察到镜下血尿及尿细胞学检查为V级。经进一步检查诊断为肾盂肿瘤后，于1982年1月行右肾输尿管全切术，随后进行内分流手术。在维持性血液透析期间，因上述手术后胃十二指肠出血行迷走神经切断术及幽门成形术。分别于1982年11月和1983年7月因肿瘤复发行全膀胱切除术及尿道切除术，并在手术期间及术后进行放疗。不幸的是，患者于1983年9月死于多发性肝转移及胃肠道出血。所有肿瘤标本均显示相同的组织学特征，即移行细胞癌G3级。本文回顾了26例日本双侧上尿路上皮肿瘤病例。
