腎原発小細胞癌の1例

Abstract

43歳男.主訴は右側腹部痛であった.血液検査で正球性正色素性貧血を認めた.血液生化学所見で肝胆道系酵素の上昇を認め, 低Na, 低Cl血症, BUN高値を認めた.CTで右腎上極に腫瘤が認められ, 下大動脈に腫瘍塞栓, 肝臓への浸潤及び腰椎への転位が認められた.又, 肺には多発する腫瘤が認められた.腎針生検により腎小細胞癌の所見を認め, 腎原発小細胞癌肺転移と診断した.化学療法を施行したが, 病状が進行し5ヵ月後に死亡した

A 43-year-old male visited our hospital with the complaint of right flank colicky pain. Computed tomographic (CT)-scan and angiography showed large renal tumor with liver invasion and tumor thrombosis in the vena cava. Multiple lung and bone tumors were also recognized. Percutaneous biopsy of the renal tumor revealed small cell carcinoma. Multiple lung masses were diagnosed as metastatic tumors according to the results of bronchoscopic biopsy. Chemotherapy including cisplatinum and etoposide was performed without success. He died 6 months after the diagnosis. Autopsy specimen revealed primary small cell carcinoma of the right kidney. To our knowledge, this is the seventh case as primary renal small cell carcinoma in the world literature.