自然腎盂外溢流を生じた胃癌の尿管転移の1例

Abstract

A case of metastasis of gastric cancer to both ureters with unilateral spontaneous urinary extravasation is reported. A 49-year-old man with left back pain was admitted to a hospital on December 20, 1979. DIP showed delayed excretion and hydronephrosis on the left side with extravasation of contrast medium around the renal pelvis. He was referred to our hospital with a diagnosis of spontaneous rupture of the left renal pelvis and the suspicion of metastasis of gastric cancer to the left ureter. The patient had had subtotal gastrectomy for cancer on February 21, 1979. Left nephrectomy and ureterectomy revealed metastasis of gastric cancer to the ureter but it did not reveal any rupture in the left renal pelvis. He complained of right back pain and oliguria on the 11th postoperative day. Right side retrograde pyelography showed a stricture at the lower part of the right ureter. At right nephrostomy, the lesion was found to be metastasis of gastric cancer. The cancer advanced immediately after surgery on the left upper urinary tract. Literature is reviewed and some discussion was made on the metastasis of gastric cancer to the ureter, and on spontaneous urinary extravasation.