子宮内膜癌の尿管再発：症例報告

Urinary tract complications can occasionally occur due to iatrogenic causes, particularly following surgical interventions for gynecological diseases. However, non-iatrogenic ureteral injuries can also occur, for example, by the cancer invasion. This study reports the case of an 83-year-old woman who was referred to our hospital for right ureteral tumor. The patient's chief complaint was macroscopic hematuria, and earlier, she had been referred to an urologist by a general physician. Right hydronephrosis and a lower ureteral tumor were observed on computed tomography and cystoscopy. Transurethral resection of the right ureteral orifice tumor had been carried out previously by an urologist. The condition was classified as urothelial cancer, Grade 2, pT1. A retroperitoneoscopic right nephroureterectomy was performed at our hospital. Extensive adhesion of the lower ureter to the surrounding tissue was detected. Consequently, the ureter, bladder cuff, and small intestine were resected en bloc. The pathological diagnosis was endometrial cancer recurrence. This is the first reported case of ureteral recurrence of the endometrial cancer. The recurrence or metastasis of endometrial cancer to the urinary tract is rare. Ureteral injuries are generally subtle; therefore, clinicians must maintain a high level of suspicion. Unrecognized or mishandled ureteral injuries might result in substantial complications. Herein, we present this rare case with some previously reported similar cases in the literature.