舌根部転移をきたした腎細胞癌の1例

Abstract

66歳男性.患者は約2年7ヵ月前に左腎腫瘍で根治的左腎摘術を受け, 病理組織所見でclear cell carcinoma, grade 2, pT3aと診断された.CT, 骨シンチでは転移を認めず, 術後補助療法は行わず経過観察していた.今回, 咽頭部の違和感で受診となり, 間接鏡で舌根部に表面に白苔が付着した結節状の腫瘤を認めた.生検でclear cell carcinomaが疑われ, 舌根部腫瘍摘出術を行った.病理組織所見はclear cell carcinomaで腎細胞癌の舌根部転移と診断された.術後の全身検索で胸部CT上微小肺転移を認め, インターフェロンα, インターロイキン2の投与を開始した結果, 2年経過現在, 肺転移の増大は認めず, 舌根部や腹腔内の再発は認められていない

A 66-year-old male patient underwent left radical nephrectomy for stage III renal cell carcinoma (RCC) two years and eight months previously. He complained of discomfort at his pharynx. An otolaryngeal examination revealed a tumor about 1.3 cm in size at the base of tongue, and the tumor was resected. It was pathologically diagnosed as clear cell carcinoma and as tongue metastasis of RCC. The subsequent appearance of a minute pulmonary metastasis caused the administration of interferon-alpha and interleukin-II. At present, two years after the treatment, neither growth of lung metastasis nor recurrence of tongue tumor are noticed. Tongue metastasis of RCC is rare and its prognosis is poor. This is the 17th case reported in Japan.