腎腫瘍の統計的観察

Abstract

1) The clinical and histological findings were reported statistically on 21 patients with renal tumor who were operated or autopsied at the Urological Clinic of Hiroshima University Hospital during last 7 years (1955-1961), and in this period there were 36 outpatients of renal tumor of clinical diagnosis. 2) Incidence - Amo n g 5095 outpatients, 36 cases (0.71% were renal tumor) and this is relatively high incidence 3) Histolog i cal classification - Ten cases of Grawitz's tumor, 9 cases of papillary cancer of the renal pelvis, 2 cases of Wilms' tumor and one case of fibrosarcoma of the renal capsule. 4) Occurence of the renal tumor was two times as frequent on the right kidney as the left kidney. 5 ) Age of the patients Between 6 and 74 years old, and 14 cases (67%) of them were in the fifth and sixth decade. Sex incidence was 2.5 (male) and 1 (female). 6) Frequency of symptoms at their first visit - Hematuria ( b oth of macroscopic and microscopic) (81%), palpable tumor (65%) and pain (52.4%). 7) Average in the periods during the onset of firs t symptom to the first visit - Grawitz's tumor (16.5 months), pelvic papillary cancer (25 months), Wilms' tumor (2 months) and fibrosarcoma of renal capsule (8 months). 8) In blood examination a n emia was not so remarkable, but leucocytosis and accelerated sedimentation rate of erythrocytes were found, and some of them, showed remittent fever. 9 ) Renal function test (PSP, indigo carmine test and water test) - In most of them renal function was slightly decreased, but some of them were normal. 10) In X-ray findings, Grawitz's tumor revealed compre s sion and deformity of renal pelvis and pyramid, and pelvic papillary cancer revealed total or partial defect, stricture, deformity and compression of the renal pelvis. 11) Pulmonary metastases were foun d in 4 cases of Grawitz's tumor, 3 cases of pelvic papillary cancer and one case of Wilms' tumor, and in Grawitz's tumor, metastasis to stimband, in pelvic papillary cancer, metastasis to the liver, urinary bladder, ureter and wall of aorta, were found. In one case of pelvic papillary carcinoma, bladder carcinoma was associated. 12) Treatment - 14 cases of nephrectomy, one case of explorative laparatomy, and most of renal tumor were treated with X-ray and Tele Coo irradiation and chemotherapy pre- and post-operatively. Weight of surgically removed kidiney ranged 117 to 940 gm. 13) Suvival rate of Grawitz's tumors was over 2 years (86%), over 3 years (43%), and in papillary cancers of the pelvis over 2 years (60%), over 3 years (40%). 14) Prognosis seems not to depend upon the size of tumor but i t s malignancy and extent of metastasis. 15) A s to treatment, thymus extract was remarkably effective on 2 cases of pulmonary metastasis of Grawitz's tumor. 16) 5 cases of autops y were reported, and one case was Grawitz's tumor and the others pelvic papillary carcinoma.