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Title: 副腎癌との鑑別が困難だった後腹膜Ewing肉腫の1例
Other Titles: Retroperitoneal Extraskeletal Ewing's Sarcoma Difficult to Differentiate from Adrenocortical Carcinoma : A Case Report
Authors: 佐藤, 真彦  KAKEN_name
宮里, 実  KAKEN_name
山田, 成幸  KAKEN_name
嶋田, 修一  KAKEN_name
海法, 康裕  KAKEN_name
石戸谷, 滋人  KAKEN_name
荒井, 陽一  KAKEN_name
Author's alias: Sato, Masahiko
Miyazato, Minoru
Yamada, Shigeyuki
Shimada, Shuichi
Kaiho, Yasuhiro
Ishidoya, Shigeto
Arai, Yoichi
Keywords: Retroperitoneal space
Extraskeletal Ewing's sarcoma
Issue Date: Jun-2011
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 57
Issue: 6
Start page: 303
End page: 307
Abstract: A 15-year-old man complained of left upper abdominal distention. Ultrasonography, computed tomography, and magnetic resonance imaging (MRI) revealed a large multilocular tumor measuring 15×10×14 cm in the left retroperitoneal space. MRI showed the high intensity tumor on the T1 and T2 weighted images and enhanced septum above the left kidney. Positron emission tomography revealed high uptake(SUV max 7.9) in the marginal region. Because the left adrenal gland could not be identified on images, we diagnosed the tumor as adrenocortical carcinoma, preoperatively. In February 2010, tumor excision combined with left nephrectomy and adrenalectomy was performed via transperitoneal approach. Left adrenal gland was identified separately from the tumor, but a small tumor was observed in the gland. The pathological specimen showed sheet-like monotonous proliferation of small round cells which had glycogen. Immunostaining technique showed highly positive CD-99 and neuron specific enolase (NSE). Fluorescence in situ hybridization (FISH) showed translocation of EWS gene. Similar pathological findings were observed in the left adrenal tumor. We diagnosed the tumor as retroperitoneal extraskeletal Ewing' s sarcoma with metastasis to the left adrenal gland. Considering it a high risk, we started adjuvant VAIA(vincristine, dactinomycin, ifosfamide, and doxorubicin) chemotherapy soon after the operation. However, there was left retroperitoneal recurrence 9 months after the operation. We changed the chemotherapy regimen to gemcitabine and docetaxel and are continuing chemotherapy.
Rights: 許諾条件により本文は2012-07-01に公開
URI: http://hdl.handle.net/2433/143305
PubMed ID: 21795832
Appears in Collections:Vol.57 No.6

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