高カルシウム血症を伴った進行性腎盂尿管扁平上皮癌の2例  [in Japanese] TWO CASES OF SQUAMOUS CELL CARCINOMA OF UPPER URINARY TRACT WITH HYPERCALCEMIA  [in Japanese]

高カルシウム血症を伴った進行性腎盂尿管扁平上皮癌の2例を報告する.症例1;54歳女性,進行性右尿管扁平上皮癌の症例.著明な高カルシウム血症と好中球増多症を認め,parathyroid hormone-related peptide (PTHrP)とgranulocyte colony stimulating factor (G-CSF)が高値であった.Cisplatinと5-fluorouracilを用いた化学療法と放射線療法の併用を行い,腫瘍は縮小した.5ヵ月後に右腎盂内に腫瘍が再発し,治療開始より17ヵ月後に死亡した.症例2:54歳男性,局所リンパ節と前縦隔への転移を伴う腎盂扁平上皮癌の症例.著明な高カルシウム血症を認め,PTHrPが高値であった.UFTの内服と前縦隔転移への放射線療法を施行したが,治療開始より2ヵ月後に死亡した.我々の調べた限りでは,症例1のような同時に血清PTHrPとG-CSF高値を伴う上部尿路の扁平上皮癌の報告は本邦では3例目と思われた.

We report two cases of squamous cell carcinoma of upper urinary tract with hypercalcemia. Case 1; a 54 year old female with primary squamous cell carcinoma (SCC) of right ureter showed marked hypercalcemia and leukocytosis. High levels of serum parathyroid hormone-related peptide (PTHrP) and granulocyte colony stimulating factor (G-CSF) were detected. Although chemotherapy of cisplatin and 5-fluorouracil with radiotherapy was effective, thereafter recurrence was occurred in renal pelvis, and the patient died 17 months after the initiation of therapy. Case 2; a 54 year old male of primary SCC of right renal pelvis with local lymphadenopathy and anterior mediastinal metastases showed marked hypercalcemia. High levels of PTHrP were detected. Although the patient was administered UFT with palliative radiotherapy to the anterior mediastinum, he died 2 months after the initiation of therapy. To our knowledge, the case 1 is the third case that of the high levels of serum PTHrP and G-CSF simultaneously in squamous cell carcinoma of upper urinary tract.