他臓器転移から発見された腎細胞癌の2例

Abstract

症例1:44歳男性.左眼球突出を主訴とし入院.左腎細胞癌の肺, 骨, 眼窩転移と診断し, 経腹膜的左腎摘除術を施行.組織学的にrenal cell carcinomaと診断された.術後早期に骨転移部に一致した腰椎の病的骨折が出現し, 歩行不能となり, インターフェロンγ投与を行うも肺転移巣の増悪に加え肺炎を併発し死亡した.症例2:59歳男性.舌腫瘤を主訴とし入院, 左腎細胞癌の舌転移と診断経腹膜的左腎摘除術を行い, 組織学的にrenal cell carcinoma及び舌転移と診断した.術後2週間目よりインターフェロンαの投与を行い, 術後10ヵ月の現在, 舌以外の転移を認めていない

Two cases of rare metastases from renal cell carcinoma are reported. The first case was in a 44-year-old man presenting with left exophthalmos. Radiological examination revealed left renal tumor with metastases to paraaortic lymph nodes, left orbit, bone and lungs. Radical nephrectomy was performed. Pathological diagnosis was renal cell carcinoma, pT3aN2M1. The patient died of widespread pulmonary metastasis 5 months postoperatively. The second case was in a 59-year-old man with a complaint of tongue tumor. Histopathology of the enucleated tumor was suggestive of metastatic renal cell carcinoma. Computed tomographic scan revealed left renal tumor with regional lymph node metastasis. No other metastasis was found. Radical nephrectomy confirmed the pathological diagnosis of renal cell carcinoma, pT3bN1M1. He has been treated with interferon-alpha and has been free of recurrence for 10 months postoperatively.