気腫性腎盂腎炎を伴った乳頭状腎細胞癌の1例

Abstract

75歳女.気腫性腎盂腎炎を合併した乳頭状腎細胞癌の稀な1例を経験した.腫瘍内感染に対しては経皮的ドレナージを施行し症状が改善, 根治的腎摘出を施行しえた.乳頭状腎細胞癌に対しては, 根治的腎摘出を施行し, 現在まで27ヵ月間腫瘍の再発を認めない

A case of papillary renal cell carcinoma complicated with emphysematous pyelonephritis is reported. A 75-year-old woman with diabetes mellitus was admitted to our hospital with macroscopic hematuria and a child's head-sized firm mass in the left hypochondrium. Computed tomographic (CT) scanning revealed a huge left renal tumor with hydronephrosis. The patient had acute pyelonephritis and antibacterial therapy was initiated. Ten days later, conservative therapy was not effective and CT scan revealed emphysematous necrotic tissue in the tumor. We performed percutaneous drainage. Then dark red liquid and gas were discharged. Her general condition was improving. Left radical nephrectomy was performed. The mass was solid and pathological diagnosis was papillary renal cell carcinoma with necrotic tissue and coated by a thick pseudocapsule. She has remained free of disease for 27 months after operation.