原発性腎カルチノイド腫瘍の1例

Abstract

54歳女.甲状腺機能亢進症の治療中であったが, 腹痛, 便秘の検査の為, 入院し, 腹部CTで左腎上極部に3×3cmの低密度の腫瘍を発見, 又, 傍大動脈リンパ節腫大があり, 泌尿器科に転科して根治的腎剔出術を行った.リンパ節その他に転移は認めなかった.消化管検査で他にcarcinoid症候群を示す所見は認めなかった.剔出腫瘍の割面は淡黄色で, 組織学的に鍍銀法その他でchromograminAと非特異的enolaseの染色性が陽性, 電顕では腫瘍細胞中に神経分泌顆粒(dense core granule)を多数認めた.手術後13ヵ月で転移や再発を認めていない.腎の原発性carcinoidは稀で, 本例は26例目の報告である

A 54-year-old woman was referred to our institute because of abdominal pain and constipation. The computed tomography of the abdomen revealed a 3 x 3 cm of low density tumor at the upper pole of the left kidney and para-aortic lymphadenopathy. Gastrointestinal investigation revealed no particular findings suggesting a carcinoid syndrome associated with the left kidney tumor. The specimen of the resected tumor showed staining pattern specific to carcinoid tumor; positive staining for chromogranin A and neuron-specific-enolase. Electron microscopy confirmed the presence of dense-core granules in the tumor cells. No evidence of metastasis or recurrence was noted for 13 months after the operation. This was a very rare case of primary renal carcinoid, representing the 26th case in the literature.