肺転移にて発見された副腎外褐色細胞腫の1例

Abstract

34歳男.検診で肺野の異常陰影を指摘された.精査で右腎腫瘍を認め, 右腎摘除術を施行した.腫瘍と大血管との剥離操作のさい高血圧発作が出現し, 褐色細胞腫を疑った.摘出標本の病理組織学的検査において, 大型で胞体がやや淡明な核の多形性を示す腫瘍細胞が認められたため褐色細胞腫と考えられた

A 34-year-old man was referred to our hospital for small lung nodules. An imaging study including a computed tomographic scan and magnetic resonance imaging showed bilateral lung tumors and huge mass arising from the lower pole of the right kidney as well. The patient underwent right radical nephrectomy in May 2002. Pathological examination revealed that the tumor was pheochromocytoma, which developed from extra-adrenal tissue. In 6 cycles of CVD systemic chemotherapy (Cyclophosphamide 750 mg/m2, Vincristine 1.4 mg/m2, Dacarbazine 600 mg/m2), the lung tumors were decreasing in size, and were removed by a surgical procedure in January 2003. Pathological examination revealed that the lung tumors were pheochromocytomas metastasized from the primary tumor. He is alive without evidence of disease 5 months after the lung operation.