腎周囲組織に発生したMalignant fibrous histiocytoma(MFH)の1例

Abstract

75歳女.人間ドックの腹部超音波検査で右腎外側に腫瘍を指摘され, 受診した.腰痛を感じる他は, 自覚症状は認めなかった.画像所見などから, 後腹膜腫瘍と診断し, 手術を施行した.腫瘍は肝, 十二指腸など周囲臓器との強固な癒着を認めた.腫瘍及び右腎摘除術となった.病理組織学的所見により, Malignant fibrous histiocytoma(MFH)と診断した.画像上は肺, 骨, リンパ節などへの転移は認められなかった.高齢で左腎が萎縮し, 術後のクレアチニンクリアランスが低値であるため, 追加治療は行わなかった.術後9ヵ月で再発転移なく, 血清クレアチニンが若干高値の他は異常なしで外来通院中である

A 75-year-old woman was admitted to our hospital with an extremely large retroperitoneal tumor that had been detected with ultrasound on a routine health check. She had no complaint except lumbar pain. Computed tomography revealed a heterogenous tumor located outside the right kidney which was enhanced gradually. Doppler ultrasound showed mild vascularity in the tumor. We performed tumorectomy and right nephrectomy because the tumor was adherent to the right kidney. The tumor was 16 x 11 x 7 cm in size and weighed 621 g. The histopathological diagnosis was malignant fibrous histiocytoma. The tumor was considered to have arisen from perirenal tissue.