腎自然破裂で発見された腎細胞癌の1例

Abstract

50歳男.腎自然破裂で発見された, 腎細胞癌例を報告した.破裂が被膜外出血の場合, 術前診断は困難であることが多いが, 腎細胞癌の自然破裂の可能性も念頭において治療にあたるべきである

A case of renal carcinoma presenting as spontaneous renal rupture is reported. A 50-year-old man was admitted to our hospital with the chief complaint of left lumbal pain. There was no evidence of recent trauma. Intravenous pyelography showed extravasation of perirenal area and space-occupying lesion at the left upper pole of the kidney. Left perirenal hemorrhage was found on computed tomography (CT scan). Suspecting extracapsular hemorrhage caused by rupture of the renal tumor, we performed nephrectomy. Histological diagnosis was renal cell carcinoma, alveolar type, clear cell subtype, grade 2, INF alpha, pT2. The patient has been well without local recurrence or distant metastasis for 9 months after the operation. To our knowledge, this is the 16th case or renal cell carcinoma with spontaneous rupture, reported in the Japanese literature, and the 7th case of extracapsular renal rupture.