巨大腎嚢胞に合併し,黄色腫との鑑別困難であった腎癌の1例

Abstract

A case of renal cell carcinoma accompanied by a giant cyst in a 69-year-old male patient is reported. The patient consulted a physician in our Hospital for bellyache on the left abdomen. Because giant cyst in the left kidney and intracystic hemorrhage were suspected by computed tomography diagnosis, the patient was transferred to the Department of Urology, As a tumor-like mass was detected in the cyst by ultrasound echo diagnosis, transperitoneal extirpation of the left kidney was conducted on May 8, 1985. At operation, a giant unilocular cyst covered with hypertrophic fibrous capsule including much coagula was observed. The inner wall of the cyst was covered with many deeply yellow torous lesions of sizes ranging from those of a wheat grain to thumb. Histologically, the lesions consisted of a cell group supposedly of histiocyte origin accompanied by cellular infiltration of lymph cells, and xanthoma was deeply suspected. However, as it was difficult to distinguish from the clear cell subtype of renal cell carcinoma, examination by an electron microscope was conducted and the final diagnosis of renal cell carcinoma was made. The post-operative course of the patient was good and no recurrence or cancer metastasis was observed as of January, 1986.