[Choriocarcinoma of the renal pelvis: a case report].
A 68-year-old male presented to our hospital complaining of gross hematuria. Intravenous pyelography subsequently demonstrated a left non-visualized kidney, and he was admitted for further evaluation. Cystoscopy revealed a bladder tumor around the left ureteral orifice and retrograde pyelography showed a filling defect in the left renal pelvis. The urinary cytology from the left renal pelvis indicated class IV, and the microscopic findings of a bladder biopsy demonstrated grade 1 transitional cell carcinoma. We performed transurethral resection of bladder tumor (TUR-BT) followed by left nephroureterectomy with bladder cuff. The pathological diagnosis was high grade transitional cell carcinoma with choriocarcinomatous component. After the operation, the serum human chorionic gonadotropin-beta (hCG-beta) level was slightly elevated, and the combination chemotherapy with methotrexate, vinblastine and cisplatin (MVC) was administered. Although the serum hCG-beta level fell to 0.1 ng/ml, after two courses of MVC chemotherapy, bilateral pulmonary metastases appeared in the chest X-ray with increasing hCG-beta levels. Salvage chemotherapy with cisplatin, etoposide and bleomycin (PEB) was performed. After two courses of PEB chemotherapy, the serum hCG-beta level fell to within the normal range and all pulmonary metastases disappeared.
Hara
S
S
Department of Urology, Keio University School of Medicine.
Ito
K
K
Nagata
H
H
Tachibana
M
M
Murai
M
M
Hata
J
J
D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D002822:Choriocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D007682:Kidney Pelvis; D008175:Lung Neoplasms / Q000556:secondary / Q000628:therapy; D008297:Male; D009378:Neoplasms, Multiple Primary; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*