甲状腺癌の両側腎転移の1例

Abstract

66歳女.肉眼的血尿が出現した.両側腎腫瘍を指摘され, 入院した.血尿は次第に強くなり, 著しい貧血を認め輸血をしなければ失血死の危険があった.左腎細胞癌の診断のもと血尿のコントロール目的で左腎摘出術を施行した.病理組織学的所見は, 甲状腺乳頭状癌の左腎転移と考えた.術後経過良好で一旦退院になったが2ヵ月後に再度血尿を呈し, 止血目的で右腎摘出術を緊急に施行した.病理診断は甲状腺乳頭腺癌の右腎転移であった.術後は血液透析を導入したが, 1ヵ月後に誤嚥性肺炎で死亡した

A 66-year-old woman was admitted with a chief complaint of macroscopic hematuria. She had a past history of mediastinal tumor that had been surgically treated 11 years earlier and had been pathologically diagnosed as papillary thyroid cancer. Enhanced computed tomography demonstrated slightly enhanced renal tumors in both kidneys. Endoscopic findings showed bleeding from the left ureteral orifice. To control macroscopic hematuria, left nephrectomy was performed. Since, two months late severe bleeding occurred from the right ureteral orifice, right nephrectomy was performed and hemodialysis was initiated. The pathological findings of the bilateral renal tumors were papillary thyroid cancer suggesting metastases from the primary mediastinal tumor.