無症状に経過した巨大副腎皮質癌の1例

Abstract

A case of nonfunctioning adrenocortical carcinoma was found in a 25-year-old woman. Physical examination revealed nothing particular, but an elastic hard mass with smooth surface was palpable three fingerbreadths beneath the left costal margin. Laboratory data including urinary excretion of 17-KS and 17-OHCS were within normal range. IVP, abdominal aortography and retroperitoneal pneumography revealed that a large mass was located in the retroperitoneal space, displacing the left kidney downward. Under diagnosis of retroperitoneal tumor, exstirpation was performed by extraperitoneal approach. A large tumor was found just above the kidney and it had hard adhesion with the surrounding tissues especially with the kidney. The adrenal gland could not be found and adrenal artery run into the exstirpated tumor. It was elastic hard in consistency and was 8×9×14cm in size, 920 g in weight and encapsulated with thick fibrous membrane. The cut surface was grayish yellow with scattered necrotic and hemorrhagic region. The histological examination proved an adrenocortical carcinoma with invasion into the capsule and veins.