移植腎機能廃絶後に発症した両側性固有腎細胞癌の1例

Abstract

47歳男.慢性腎不全で血液透析導入した.実母をドナーとして生体腎移植術施行したが, 徐々に移植腎機能の低下が進み, 移植腎機能廃絶により血液透析再導入された.免疫抑制剤は血液透析再導入後漸減中止した.スクリーニングCTで右腎腫瘍を認め経過観察していたが, 増大傾向を認めた為精査加療目的で入院となった.画像診断等により後天性嚢胞性腎疾患(ACDK)に発生した両側性固有腎細胞癌と診断し, 経腹的に両側腎摘除術を施行した.両側の副腎は温存した.左右共にpT1であり, 静脈浸潤を認めなかった為, 追加治療は行わず, 略治退院となった.術後30ヵ月の現在, 再発・転移は認めていない

We report a case of renal cell carcinoma arising in bilateral original kidneys after failure of transplant graft function. A 47-year-old man had received a living related renal transplantation on December 10, 1985. He had resumed hemodialysis (HD) therapy because of graft failure on January 8, 1996. Periodic computed tomography (CT), after resumption of HD, revealed multiple cystic change in bilateral original kidneys and a mass in the right kidney. He was referred to our hospital on August 4, 1998 for management of the increased right renal lesion. Abdominal angiography demonstrated a hypervascular and solid mass not only in the right kidney but also in the left kidney. He underwent transperitoneal bilateral nephrectomy. Histopathological examination revealed renal cell carcinoma, bilaterally, with alveolar type and granular cell subtype. He was free of evidence of recurrence and metastasis for 30 months after nephrectomy.