超音波パワードップラー法が有用であった単純性腎嚢胞壁に発生した腎細胞癌の1例

Abstract

54歳男.右背部痛が出現し, 精査加療目的で受診となった.排泄性腎盂造影検査で, 右尿管結石と右水腎症及び右腎下極の腫大を認め, 腎超音波検査及び造影CTでは腎嚢胞壁に充実性腫瘤を認めた.以上より, 単純性腎嚢胞壁に発生した腎細胞癌を疑い, 腰背部斜切開で右腎摘出術を施行した.嚢胞内容液細胞診ではClass IIであった.腎細胞癌は, 嚢胞壁の腫瘤部以外の被覆上皮には認められなかった.術後経過は良好で, 12ヵ月後現在も再発は認めていない

We present a case of renal cell carcinoma in the wall of a simple renal cyst. A 54-year-old man visited our hospital with a complaint of right back pain. Ultrasound study revealed right hydronephrosis, a ureteral stone, and a 9 x 8 cm renal cyst, with a tumor, 2 cm in diameter, in the cyst wall. Power Doppler Ultrasound and enhanced computed tomography demonstrated hypervascularity of the tumor. Clinically, he was diagnosed as renal cell carcinoma and nephrectomy was performed. Pathological findings of the tumor showed clear cell carcinoma in the wall of a simple renal cyst. Twelve months after the nephrectomy, he was free from recurrence.