浸潤性発育を示したBellini管癌の1例

Abstract

39歳男.Bellini管癌, 乳頭腺癌型(pT3bN2M0)の症例を報告した.被膜形成を認めず, 浸潤性の発育を示し, 非常に特徴的な肉眼・画像所見を示した.この所見は過去に報告されている腎発生の移行上皮癌と類似していた.左根治的腎摘除術術後の補助療法として尿路上皮癌に準じたMVAC療法を施行した

We report a case of Bellini duct carcinoma of the left kidney with invasive growth pattern. A 39-year-old man was admitted to our hospital with the chief complaint of gross hematuria. Ultrasonography showed left renal swelling but normal reniform configuration of the kidney was maintained. Computed tomography demonstrated a low density tumor infiltrating into the renal cortex and with tumor extension into the renal vein. Renal angiography revealed a hypovascular tumor. We suspected a left renal cell carcinoma with tumor extension into the left renal vein, and performed radical nephrectomy. Macroscopically, the resected kidney had a normal outer contour. The tumor with infiltrative growth pattern existed in renal medulla. Histopathologic examination revealed a papillary adenocarcinoma originated in Bellini duct (pT3bN2M0). The patient underwent systemic chemotherapy (M-VAC). This case showed invasive growth pattern, which were different from the usual renal cell carcinoma and Bellini duct carcinoma.