検診にて偶然発見された腎血管周皮腫の1例

Abstract

58歳男性.患者は検診で左腎腫瘍を指摘され受診となった.超音波検査では左腎に60×50mmの低エコーを示す腫瘍を認め, 腹部CTでは左腎下極内側に腫瘍が認められた.更に肺CTでは左S9に5mmの腫瘍が認められ, MRIではT1強調像で等信号, T2強調像で高信号の腎腫瘍が認められた.経腰的根治的左腎摘除術を施行したところ, 病理所見にて腎血管周皮腫と診断された.一方, 肺腫瘍については呼吸器科で経過観察となったものの, 腎手術2ヵ月後のCTで右肺野5mm, 左肺野10mmの増大傾向を認め, 生検で腎血管周皮腫の肺転移と診断された.化学療法を2コース施行したが, 肺転移巣は不変で, 現在外来にて厳重な経過観察中である

We report a case of renal hemangiopericytoma which was incidentally discovered by ultrasonography at a health screening. A 58-year-old man was admitted to our hospital for close examination of the renal tumor. Computed tomography revealed the left renal tumor, 60 x 50 mm in size, which was well enhanced with contrast medium. Magnetic resonance imaging revealed an isointensity mass (T1-weighted) and high-intensity mass (T2-weighted) at the left kidney. Radical nephrectomy was performed on suspicion of left renal cell carcinoma. Histopathological examination revealed renal hemangiopericytoma. The present case is the 7th in the Japanese literature.