転移性腎腫瘍の3例

Abstract

症例1:64歳男.1995年5月食道癌(扁平上皮癌)に対し右開胸開腹食道亜全摘術を施行した.7ヵ月後右腎腫瘍を指摘され, 右根治的腎摘除し, 転移性扁平上皮癌であった.7ヵ月後死亡した.症例2:63歳男.右気胸に対する手術中, 右肺に腫瘍を認め右肺上葉を切除した.腺癌であった.術後, 腹部CTで右腎腫瘍を指摘され, 右根治的腎摘除術を施行した.組織学的に転移性中分化型腺癌であり, 7ヵ月後死亡した.症例3:69歳男, 原発性右肺癌に対し右中葉切除, 下葉部分切除を行った.腺癌であった.術前後の腹部CT, エコーで左腎嚢胞の増大を認め, 開腹生検, 転移性腎癌と診断し, 右腎摘除術を施行したが, 10ヵ月後死亡した

Since solitary metastatic renal tumors are not commonly diagnosed before death, the conclusive treatment of the metastatic renal tumor has not been established. We report three cases of metastatic renal tumors and discuss the indication of surgical therapy for metastatic renal tumors. The first case was in a 64-year-old male who underwent esophagectomy for squamous cell carcinoma. Seven months after the operation, a right renal tumor was found. The second case was in a 63-year-old male who underwent right upper pneumonectomy for adenocarcinoma with a right renal tumor, which seemed to be a solitary metastasis. The third case was in a 69-year-old male who underwent right pneumonectomy for adenocarcinoma. One month after the initial operation, a left renal cystic tumor was found. Since, in all cases, the tumors seemed to be solitary metastatic renal tumors without any other metastatic lesions, nephrectomy was performed. Unfortunately, however, the nephrectomy did not improve prognosis and all three patients did within 10 months after the nephrectomy. Nephrectomy may not be recommended in cases of metastatic renal tumors even if no other metastatic lesions can be found by various image examinations.