CEA産生集合管癌(ベリニ管癌)の1例

Abstract

61歳男.左腎腫瘤性病変の精査加療目的に当科入院した.HE染色像で特徴的所見を有し, 更に近位尿細管のマーカーであるビメンチン, EMA(epithelial membrane antigen)及び高分子サイトケラチンに関しては, 陽性或いは強陽性であったことから腎実質性腫瘍と診断し, 経腹膜的に根治的左腎摘除術及び腎門部リンパ節郭清術を施行した.その後, 外来にて姑息的治療のみで経過観察を行ったが, 転移巣は増大し術後約20ヵ月後に死亡した

We report a case of collecting duct carcinoma (Bellini duct carcinoma) producing carcinoembryonic antigen (CEA). A 61-year-old man visited our hospital because of a left renal mass detected by ultrasonography in an other hospital. Computed tomography showed a low density tumor measuring about 3 cm in the left kidney. Angiography demonstrated a hypovascular tumor. The serum level of CEA was increased to 20 ng/ml. (normal < 7 ng/ml). Left radical nephrectomy was performed. Histological examination revealed collecting duct carcinoma with papillary growth (T1aN1M0). Cancer cells showed a positive immunohistochemical staining for CEA. Under a diagnosis of CEA-producing collecting duct carcinoma of the left kidney, the patient underwent systemic chemotherapy (M-VAC). The serum level of CEA decreased to the normal level after the nephrectomy, but six months postoperatively, metastatic bone tumor at the left pelvic bone was revealed on the plain film and at the same time, the CEA level was increased again.