A long-term dialysis patient with a urothelial tumor involving the renal pelvis, ureter, and bladder: a case report

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  • 長期血液透析患者に生じた腎盂尿管膀胱腫瘍の1例
  • 症例報告 長期血液透析患者に生じた腎盂尿管膀胱腫瘍の1例
  • ショウレイ ホウコク チョウキ ケツエキ トウセキ カンジャ ニ ショウジタ ジンウニョウカン ボウコウ シュヨウ ノ 1レイ

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Abstract

<p>A 69-year-old female who had been on hemodialysis because of chronic glomerulonephritis since the age of 53 was admitted to our department with a complaint of macroscopic hematuria. Bladder fiberscopy revealed a few small bladder tumors, which were removed using transurethral resection (TURBT). Thereafter, plain computed tomography (CT), bladder fiberscopy, and washing cytology were performed to detect recurrence. Three years after the TURBT, plain CT revealed right-sided renal cancer. Therefore, a laparoscopic right-sided retroperitoneal nephrectomy was carried out. A histopathological examination demonstrated right-sided renal pelvic carcinoma. In addition, at 1 month after the nephrectomy plain CT showed left-sided ureteral cancer, and retroperitoneal laparoscopic total left nephroureterectomy, total bladder cystectomy, and residual right ureterectomy were performed. Colpocleisis for a transvaginal enterocele was conducted at 1 postoperative year. The patient has not suffered any other complications since. It is often difficult to detect urothelial tumors in hemodialysis patients because they can suffer from oliguria or anuria; therefore, such tumors tend to be diagnosed late. Many hemodialysis patients develop urinary tract tumors, such as kidney or bladder tumors, and clinicians should examine such patients for accompanying pelvic or ureteral tumors. Here, we report the case of this hemodialysis patient along with a review of the relevant literature.</p>

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