腹腔鏡を併用して二期的に治療した両側同時性腎細胞癌の1例

Abstract

70歳女.6年前より糖尿病にて経口血糖降下剤の服用を開始したが, 血糖コントロール不良の為精査目的で近医に入院したが, 腹部超音波, 腹部CT検査で両側腎腫瘍を指摘され転院となった.入院後の画像検査所見より, 両側腎腫瘍, 両側腎細胞癌の疑いで二期的に左腎部分切除術及び腹腔鏡下右腎摘出術を施行した.左右共, 腫瘍周囲の癒着と腎静脈の腫瘍塞栓を認めず, 腎門部のリンパ節腫脹も認めなかった.術後, 有意な腎機能の低下を認めず, 合併症もなく退院した.補助療法は施行せず, 術後1年4ヵ月経過現在も再発, 転移の兆候なく定期的外来通院を行っている

We describe a case of bilateral synchronous renal cell carcinoma. A 70-year-old female was admitted to our department because of further examination for bilateral renal masses. Computed tomographic scanning and ultrasound examinations revealed bilateral solid enhanced renal masses, and bilateral renal cell carcinomas were suspected. First, partial left nephrectomy was performed. On the 21th day after the first operation, we confirmed the recovery of the left kidney, and performed right nephrectomy laparoscopically. The histopathological diagnosis revealed bilateral renal cell carcinomas. The patient is alive with no metastatic lesions and no recurrence at 16 months after the operations.