珊瑚状結石に合併した腎腺腫の1例

Abstract

A case of renal adenoma associated with staghorn calculus is reported. The patient was a 52-year-old man. In 1973, he underwent an ileal conduit because of tuberculous contracted bladder and impediment in renal function. At that time, small calculi were already present in the right kidney. Later, in the left kidney, calculi developed into staghorn calculus. An ureteral calculus was also present in the right side and contracted kidney was observed. In 1983, he suffered from continuous left abdominal pain and macroscopic hematuria. Left nephrolithotomy was performed on August 23, 1983. During surgery, a yellow subcapsular flat mass the size of the tip of an index finger was found in the upper pole of the left kidney and was easily excised. An 11 cm incision was made in the renal parenchyma and the calculi were completely removed. At the center of the incised region, biopsy was performed. The wound was closed by the one-layer interrupted parenchymal suture method designed by Taguchi. Pedicle clamp time was 37 minutes and postoperative macroscopic hematuria was seen for only two days. The postoperative course was uneventful. The resected tumor was 18 X 16 X 10 mm in size. Histological examination revealed presence of fibrous capsules and papillary or tubular proliferation of cells which were suspected to have originated in the renal tubule. Also, there were scattered nests of foam cells. On the basis of these histological findings, the mass was diagnosed as renal adenoma. In addition, examination of the biopsied parenchyma also revealed small multiple adenomas, which were supposed to be remaining in the left kidney.