後腹膜機能性Paragangliomaの2例

Abstract

症例1:52歳男.動悸, 腹痛, 胸痛, 頭痛を主訴として入院した.臍右上に超手拳大・弾性硬・呼吸性移動のない腫瘤を触知, 血中, 尿中カテコラミンの高値を認めた.超音波, CT, MRI, 血管造影で右腎と下大静脈の間に大きな腫瘍を認め, 後腹膜機能性paragangliomaと診断し, 腫瘍を摘出, 組織学的に確認した.症例2:68歳女.糖尿病の精査のため入院, 左後腹膜腫瘤を発見, 血中, 尿中ノルアドレナリンの高値を示し, 超音波, CT, MRI, 血管造影で左腎下極に腫瘤を認め, 後腹膜機能性paragangliomaと診断し, 腫瘍摘出, 組織学的に確認した.術後血糖値及び血中, 尿中ノルアドレナリン値は正常化した

We report two cases of retroperitoneal functioning paraganglioma. Case 1: A 52-year-old male patient was admitted to our hospital for further examination of pulsating abdominal pain with chest pain and headache. Overfist-size smooth-surfaced hard mass was palpated at the right upper abdominal quadrant. Catecholamine levels in serum and urine showed marked elevation. Computed tomographic (CT) scan, magnetic resonance imaging (MRI) and angiography revealed a large tumor between the right kidney and aorta. He underwent surgical removal of the tumor and histological examination revealed paraganglioma. His chief complaints disappeared postoperatively. Case 2: A 68-year-old female patient was admitted to our hospital for control of diabetes. An abnormal mass was shown ultrasonically at the left renal region by routine screening examination. A marked increase of noradrenaline in serum and urine was observed. Abdominal CT scan, MRI and angiography revealed a retroperitoneal tumor which was located adjoining to the lower pole of the left kidney. The tumor was removed transabdominally. Histopathological studies showed paraganglioma. After the operation her blood sugar and noradrenaline levels decreased to the normal range.