術前に下大静脈腫瘍血栓による肺梗塞を発症した右腎細胞癌の1例

Abstract

71歳男.下大静脈腫瘍血栓が術前に遊離して肺梗塞を生じたが, 右肺動脈内の腫瘍塞栓を原発巣と同時に摘除することで良好な結果が得られた

A 70-year-old male with right renal mass incidentally found by annual check-up using ultrasound, was referred to Department of Urology, Jikei University Affiliated Kashiwa Hospital. He was diagnosed as having right renal cell carcinoma with vena caval tumor thrombus extending above the diaphragm (T3c) preoperatively. The day before the scheduled day of operation, right pulmonary infarction caused by spontaneous migration of vena caval tumor thrombus of right renal cell carcinoma developed. Although arterial blood gas findings were poor, he only had low grade chest pain without shock. Therefore, we successfully performed right radical nephrectomy and thrombectomy of right pulmonary artery the next day. He was discharged 42 days postoperatively, but, he died from acute heart failure 9 months after the operation.