腎細胞癌の臨床的観察

Abstract

Ten cases of renal cell carcinoma were clinically studied. Symptoms: Initial symptom was hematuria in seven patients, and gastro-intestinal disorder or general malaise in two patients. No patient had complete set of triad-hematuria, mass and pain. Pyrexia seen in three cases disappeared after nephrectomy. Diagnosis: Renoscintigram was more useful than pyelogram when a tumor was relatively small and located near the capsule. Nephrotomography was helpful for differential diagnosis from cyst. Treatments: As a rule, transperitoneal approach was taken. In two cases of big renal tumor weighing more than 1000 grams, nephrectomy was successfully performed under general hypothermic anesthesia. All the cases received postoperative radiation therapy, and two received preoperative irradiation with clinical effect. As to chemotherapy, continuous infusion of 5-fluorouracil into the renal artery was tried for 13 days in one patient. Prognostic factors: Out of factors affecting prognosis, intravenous invasion or thrombosis of the tumor was considered most significant.