対側腎周囲脂肪組織への転移をきたした腎細胞癌の1例

Abstract

62歳男.57歳時に左腎摘除術後の病理組織検査で腎細胞癌, 明細胞亜型と診断され, 4年後に腎細胞癌の転移による右大腿骨遠位部の骨腫瘍に対し病巣掻破を施行された.その1年後の腹部CTで右腎極下の腫瘤性病変を指摘された.腹部CT, 腹部MRI所見より右腎周囲脂肪組織への転移と診断し, 腫瘤摘出術を施行した.病理学的所見は腎細胞癌, 明細胞癌で, 左腎の病理組織所見とほぼ一致し, 骨転移先行の血行性転移と判断した.術後はインターフェロンとシメチジンによる免疫療法を施行した.術後8ヵ月経過した現在, 再発の徴候はない

Extremely rarely renal cell carcinoma metastasizes to the contralateral perirenal fat. A 57-year-old male was admitted with macroscopic hematuria and lower left abdominal pain in December 1994. He was diagnosed with left renal cancer, and underwent left radical nephrectomy (RCC pT2, grade 1) in January 1995. Followup imaging studies showed a tumor arising from the right perirenal fat in 5 years. Tumor excision was performed in May 2000. Pathological findings revealed renal cell carcinoma growing in the fat, which had the same, pathology as the left renal cancer.