後腹膜腔原発,CA19-9陽性Mucinous adenocarcinomaの1例

Abstract

44歳女.嚢胞性腎細胞癌との鑑別が困難であった後腹膜腔原発の粘液性嚢胞腺癌の症例について報告した.微熱を主訴とし, 左腎部嚢胞性病変のため精査目的のため入院となった.CTおよびMRIでは左腎下極部に石灰化および壁肥厚を伴う嚢胞性病変を認め, 嚢胞性腎細胞癌を疑い経腹的に左腎摘出術を施行した.嚢胞性病変はGerota's fasciaと強く癒着していたが, 左腎とは境界明瞭であり, 腎原発の嚢胞性腫瘍ではないと考えられた.内容液は黄褐色調の粘液であり, 嚢胞壁内浸潤を認めたが壁外への浸潤は認められなかった.micinous adenocarcinomaと診断し, CA19-9のみ陽性であった.術後は再発, 転移を認めず経過良好であった

We report a case of retroperitoneal mucinous adenocarcinoma in a 44-year-old woman, who was admitted to our hospital complaining of low grade fever. Computed tomography and magnetic resonance imaging demonstrated a cystic tumor located at the lower pole of left kidney with irregular wall, which was enhanced by contrast medium. Open surgery was performed. Macroscopically, the tumor was clearly separated from the left kidney, and diagnosed as retroperitoneal in origin. Histopathological diagnosis was mucinous adenocarcinoma of retroperitoneum and immunohistochemical staining was positive for CA19-9, but not for CA125. The patient had no recurrence for 19 months post-operatively.