食道原発の転移性腎腫瘍

Abstract

In August 1987, a 66-year-old man was hospitalized because of macrohematuria and right flank pain. He had undergone resection of middle and lower part of the esophagus with esophagogastrostomy for esophageal carcinoma on April 16, 1984. Computed tomography revealed a solid, irregular, low density area in the upper pole of the right kidney and the right lobe of the liver. Arteriography showed a hypovascular mass in the upper pole of the right kidney, and several small tumor stains in the liver. At cystoscopic examination, the urinary bladder was normal and blood flowing from bilateral ureters was not seen. Cytological study of urine sediment disclosed squamous cell carcinoma. The patient was treated with systemic chemotherapy, but not improved. He died 6 months later, and the autopsy demonstrated widespread metastasis in various organs including the right kidney and liver. No recurrence was found in the residual esophagus. The kidney is the sixth organ of metastasis following the lung, liver, bone, adrenal, peritoneum and mesenterium. Although metastasis to the kidney is relatively common in autopsy, it is uncommon to be manifest clinically.