孤立性対側副腎転移を伴った腎細胞癌の1例

Abstract

症例は73歳女で, 定期検診の腹部CTで右腎腫瘤を指摘され, 当科紹介となった.腹部CT, 腹部MRI, 血管造影所見より, 左副腎腫瘤は内分泌学的に非活性であり, 画像上, 右副腎には転移を認めず, 右腎腫瘍及びその左副腎転移の診断のもと, 右副腎温存根治的右腎摘除術及び左副腎腫瘍摘除術を施行した.摘出標本は径6cm大の腎腫瘍と4cm大の副腎腫瘍であった.病理組織所見は腎細胞癌, alveolar type, common type, clear cell subtype, G2≫G3, pT2であり, 副腎腫瘍の所見も原発巣に一致していた

A 73-year-old female visited our department with right incidentally-found renal tumor, which was revealed by follow-up computed tomography (CT) on an annual physical check-up. CT also showed a left adrenal mass that was 4 cm. Further evaluation suggested right renal cell carcinoma and left adrenal metastasis. The patient, therefore, underwent right-adrenal-gland-sparing radical nephrectomy and left adrenalectomy. The pathology report indicated renal cell carcinoma with contralateral adrenal metastasis. A case of contralateral adrenal metastasis from renal cell carcinoma is not common clinically. Furthermore, whether ipsilateral adrenalectomy should be performed in such a case is still controversial at this stage.