20歳女子にみられた腎細胞癌の1例

Abstract

A 20-year-old female, who was one of identical twins, was transferred from an another hospital for further therapy of a right renal tumor. There was no history of hematuria, flank pain. Routine laboratory studies were within the normal range. On excretory urogram, the tumor, 7 x 9 cm in diameter, was demonstrated in lower pole of the right kidney. A selective renal arteriography revealed that the central area of the tumor was rather hypovascular, but, some neovascularity was seen in the peripheral area. Pedal lymphography, chest X-ray and bone survey showed normal findings. A right nephrectomy was carried out. Grossly, the tumor in the lower pole of the kidney was well demarcated by a pseudocapsule and had massive necrotic areas. Pathological sections revealed a granular cell adenocarcinoma of the right kidney. No extension into the peripheric fat was present. The patient remains well and free of recurrent tumor one year post-operatively. We discussed the diagnosis and prognosis of renal cell carcinoma in young adults in the literature.