腎血管筋脂肪腫自然破裂に対し動脈塞栓術を施行した2例

Abstract

症例1(22歳女).背部痛, 左側腹部痛を主訴とした.腹部CTにて左腎腹側に出血と血腫が混在する直径10cmの腫瘤を, 腎動脈造影検査にて多数の腫瘍血管を伴う腫瘍とextravasationを認め, 腎血管筋脂肪腫(AML)の破裂と診断した.経カテーテル的動脈塞栓術(TAE)にて症状は改善したが腫瘍の縮小効果は乏しく, 2度の追加TAEを施行した後も6.5cmの腫瘍が残存するため, 定期的な経過観察を行っている.症例2(74歳女).右下腹部痛を主訴とした.腹部CTにて右腎の内側から背側にかけてhigh density areaを, 腎動脈造影検査にて径1cm程の動脈瘤とextravasationを認め, AMLの破裂と診断した.TAE施行にて症状は改善し, 術後7ヵ月のCTにてAMLの著明な縮小がみられた.TAEはAML自然破裂に対する有用な治療法であると思われた

We report two cases of spontaneous rupture of renal angiomyolipoma (AML). In the first case, a 22-year-old woman was admitted with lower abdominal pain. She was diagnosed with rupture of left renal AML. Transcatheter arterial embolization (TAE) was performed for three times to preserve renal function, and the size of AML decreased to 6.5 cm from 10 cm. In the second case (74-year-old woman), the chief complaint was lower abdominal pain. The clinical diagnosis of this patient was rupture of right renal AML. The size of this AML markedly reduced due to TAE. TAE is an effective therapy for rupture of renal AML.