健診を契機に発見された尿路系重複癌の1例

Abstract

58歳男.血清prostate-specific antigen(PSA)の高値を会社の検診で指摘された為, 当院を受診した.針生検により前立腺両葉に癌が認められ, 組織学的には中分化>低分化腺癌であった.MRI及びCTでは, 前立腺周囲への浸潤, リンパ節転移は認められず, 骨シンチでも骨への異常集積は認められなかった為, 病期B2と診断された.腹部超音波検査では左腎に腫瘍が認められた.CT及び血管造影でも左腎腫瘍が認められた.根治的左腎切除を施行し, 病理学的には混合型の腎細胞癌であった.(病期pT2b, pNO, pMO)

A 58-year-old male with left renal cell carcinoma and prostatic carcinoma occurring synchronously, is reported. He visited our hospital, because of the high level of serum prostate-specific antigen (PSA) pointed out in a health screening by his company. Prostatic cancer was detected in both lobes of the prostate by needle biopsy specimens and histopathology represented moderately > poorly differentiated adenocarcinoma. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed no cancer invasion beyond the prostate and no lymph node metastasis. Bone scintigram showed no abnormal RI accumulation to bone. Therefore, his prostatic cancer was considered to be at stage B2. Abdominal ultrasound echogram showed the mass lesion in the left kidney. CT and angiogram also demonstrated a left renal tumor. Left radical nephrectomy was performed and histopathology showed a mixed subtype of renal cell carcinoma (stage: pT2b, pN0, pM0). Although 94 cases of double cancers associated with genitourinary organs have been reported in the Japanese literature, only 4 cases of double cancers of renal cell carcinoma and prostatic cancer have been reported.