京大泌尿器科における最近10年間の腎並に副腎腫瘍の統計的観察

Abstract

1) The clinical and histological findings were stat i s tically analysed on 42 patients with renal and adrenal tumor who were operated at the Urological Clinic of Kyoto University Hospital in the last 10 years (1949-1958). 2) These patients occupie d 0.24 per cent of total number of out-patients and 1.81 per cent of total number of in-patients, exhibiting an increase in this kind patient. 3) Age ranged between 3 and 69 years old and 80.9 per cent of t hem were in fifth and seventh decade. 4) Sexua l distribution of male and female was 6.4 and 1, respectively. 5) Insignificant difference was found in either side of the b o dy. 6) Hereditary diathesis of malignant tumor was found in 6 cases (14.3%). In one of the 6 cases, the diathesis was found in the parents. 7) Chief complaint most frequently en c o untered was hematuria (64.2%) followed by renal tumor (50%) and pain (16.7%). 8) It is interesting to no t e that impaired renal function (indigocarmine test) was found in most affected kidney, though 14.3 per cent of the cases exhibited normal function. 9) In X-ray findings, 86.2 per cent of the patients with parenchymal tumor of the kidney revealed compression and deformity of the renal pelvis and pyramid, 85.6 per cent of the patients with tumor of the renal pelvis revealed total or partial defect, and deformed or unclear shadow of the renal pelvis. Pneumoretroperitoneum pictures the contour of the kidney as well as its surface and adhesion to the adjacent tissue. The pneumoretroperitoneum plays as important role as aortogram for a supplementary test of PR and IVP. 10) Weight of surgically removed tumor ranged between 160 and 1110 gm. 11) In 42 cases with renal and adrenal tumor, 41 cases were operated, i n which a case of hypernephroma and 2 cases of neuroblastoma were necropsied. 12) The most frequently encountered renal tumor w ere 25 cases of hypernephroma followed by 8 cases of transitional cell cancer, a case of each adenoma, fibroma and squamous cell carcinoma. In the adrenal tumor, 4 cases of neuroblastoma and 1 case of Cushing were found. Calcification was found in one of 25 hypernephroma. 13) Pulmonary metastasis was found in 25 per cent of hypernephroma. Metastasis to the bladder and ureter was found in 62.5 per cent of renal pelvic tumor. 14) Mortality of hypernephroma within 3 years was 66.7% a nd 75 per cent for the patients with tumor of the renal pelvis which was worse than that of hypernephroma. Mortality of neuroblastoma was 100 per cent. 15) Prognosis seems not to depen d upon the size of tumor but its malignancy. 16) The best treatment is nephrectomy in possible early stage. No definite conclusion has been reached for evaluation of postoperative X-ray and chemical therapies becaues of insufficient number of cases.