腎細胞癌とオンコサイトーマが同時発生した両側腎腫瘍の1例

Abstract

症例は70歳女で, 上腹部膨満感を主訴とした.CTで右腎に内部不均一なlow densityの腫瘤を, 腎中央から下極の腹側及び左腎上極に内部均一な腫瘤を認めた.右腎動脈造影では腎中央から下極に血管増生を伴う腫瘍陰影を認めた.これらの所見から両側腎細胞癌を疑い右腎摘除術と左腎部分切除術を施行した.摘出標本の病理組織学的所見より右側は腎細胞癌, 左側はオンコサイトーマと診断した.本例のような腎細胞癌・オンコサイトーマ合併例は調べ得た限り過去日本で5例の報告があり, 両側発生例は本例が初めてであった

A case of bilateral, synchronous renal cell carcinoma and oncocytoma is reported. The patient was a 70-year-old woman. Computed tomographic scan revealed bilateral low density masses, which had a diameter of approximately 4 cm (right kidney), and 2.5 cm (left kidney). We suspected bilateral renal cell carcinomas, and performed, right nephrectomy and left enucleation of the tumor. Pathological diagnosis was right renal cell carcinoma and left oncocytoma. To our knowledge only 5 previous cases of renal cell carcinoma associated with oncocytoma have been reported in Japan. Two cases were metachronous and three cases were unilateral and synchronous. This is the first reported case of bilateral, synchronous renal cell carcinoma and oncocytoma.