エリスロポエチン産生腎腫瘍の1例

Abstract

A patient with renal cell carcinoma producing increased erythropoietin resulted m secondary erythrocytosis was presented. A 68-year-old man was admitted to our clinic with a chief complaint of macroscopic hematuria in April, 1977. Angiograms demonstrated a huge tumor of the right kidney with multiple liver metastases. Despite transcatheteral embolization of the right renal artery and progesterone therapy, the patient died in September, 1977. The histopathological study showed adenocarcinoma of the right kidney by autopsy. Since admission the patient had erythrocytosis. Bioassay and hemagglutination-inhibition assay for erythropoietin were performed. The assay of the plasma, the urine and the extract of the tumor showed that erythropoietin activity was significantly greater than normal value. In view of these results, erythrocytosis associated with the tumor appears to be secondary to the production of erythropoietin from the tumor. The literatures concerning incidence and mechanism of association between erythrocytosis and tumors were reviewed. A discussion was made about significance of estimating erythropoietin level in the clinical practice in future.