褐色細胞腫を合併した腎細胞癌の2例

Abstract

症例1は56歳女で, 高血圧の精査中, CTにより右腎細胞癌, 右副腎転移を疑われ, 精査, 加療のため入院となった.内分泌学的検査と131I-MIBG(metaiodobenzyl-guanidine)シンチにより褐色細胞腫の診断を確定した.根治的右腎摘除術を施行した.症例2は45歳男で, 胃潰瘍の精査中, 腹部CTにより右腎細胞癌が疑われ, 入院となった.検査成績, 画像所見より, 右腎細胞癌, 左副腎転移と診断した.根治的右腎摘除術, 左副腎摘除術, 左副腎摘除術を施行し, 術後ステロイド補充療法を行った.両例とも組織学的診断は腎細胞癌, 副腎褐色細胞腫であった.両例ともvon Hipple-Lindau病に特有である所見を認めなかった

Two cases of adrenal pheochromocytoma associated with renal cell carcinoma are reported. The first case was in a 56-year-old woman who had been treated for hypertension. Computerized tomography (CT) scan revealed a right renal tumor and a right adrenal mass. Endocrinological examination and 131I-MIBG scintigraphy confirmed the diagnosis of pheochromocytoma. Right radical nephrectomy was performed under stable blood pressure. The second case was in a 45-year-old man who had been treated for gastric ulcers. CT scan incidentally revealed a right renal tumor and a left adrenal mass. He was normotensive and endocrinologically normal. Right radical nephrectomy and left adrenalectomy were performed, followed by corticosteroid supplementation. In both cases, histopathological diagnosis was renal cell carcinoma and adrenal pheochromocytoma. Both patients had no clinical evidence for von Hippel-Lindau disease such as tumorous lesions of the central nervous system, spinal cord and retina, and cystic lesions of the kidney and pancreas.