摘出腎における腎細胞癌に随伴する腫瘍性病変の検索

Abstract

1)RCCの腫瘍径が80mm以下の摘除された43腎の連続全割面を検索し, 3例に微小のsatellite RCCを, 4例に良性腫瘍を認めた. 2)主腫瘍径の大きさとsatellite RCCの発見とは, 相関しなかった. 3)主腫瘍とsatellite RCCの距離は, 10～70mmであった. 4)Satellite RCCの発見と主腫瘍のgrade, stage, 脈管侵襲などの各背景因子との関連性は認められなかった

Nephron-sparing surgery was initially limited to the patients with localized renal cancer (RCC) present bilaterally or in a solitary kidney. Recently there is controversy in the indication for partial nephrectomy or enucleation to incidentally defined small RCC with normal opposite kidney. We examined the incidence of multicentricity in 43 kidneys removed for RCC with a diameter of less than 80 mm. The mean diameter of the predominant tumors was 45 mm (range 12 to 80 mm). The kidneys were serially sectioned at 5 mm intervals. Three of 43 kidneys (7%) had multiple RCC. The size of the concomitant tumors ranged from 2 to 15 mm. The multicentricity had no relation to pathological grade, stage, vascular invasion or infiltration pattern. In addition, the other 4 kidneys had 2 adenomas, 1 angiomyolipoma and 1 fibroma. Therefore we observed a 16% incidence of small renal nodules and a 7% multicentricity of RCC in the nephrectomized kidneys with normal opposite kidney.