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Title: 拡大手術と化学療法を施行した下大静脈腫瘍塞栓を伴う進行副腎皮質癌の1例
Other Titles: Advanced Adrenocortical Carcinoma with Vena Caval Tumor Thrombus Treated with Extended Surgery and Subsequent Chemotherapy
Authors: 中島, 志織  KAKEN_name
成田, 伸太郎  KAKEN_name
佐藤, 博美  KAKEN_name
五十嵐, 龍馬  KAKEN_name
奈良, 健平  KAKEN_name
神田, 壮平  KAKEN_name
沼倉, 一幸  KAKEN_name
齋藤, 満  KAKEN_name
井上, 高光  KAKEN_name
佐藤, 滋  KAKEN_name
山本, 浩史  KAKEN_name
山本, 雄造  KAKEN_name
羽渕, 友則  KAKEN_name
Author's alias: Nakajima, Shiori
Narita, Shintaro
Sato, Hiromi
Igarashi, Ryoma
Nara, Taketoshi
Kanda, Sohei
Numakura, Kazuyuki
Saito, Mitsuru
Inoue, Takamitsu
Satoh, Shigeru
Yamamoto, Hiroshi
Yamamoto, Yuzo
Habuchi, Tomonori
Keywords: Adrenocortical carcinoma
Tumor thrombus
Issue Date: 31-Oct-2019
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要 = Acta urologica Japonica
Volume: 65
Issue: 10
Start page: 397
End page: 402
Abstract: A 36-year-old female was referred to our hospital for a giant abdominal mass found by ultrasound examination. A computed tomographic scan showed a large retroperitoneal mass measuring 11 cm in diameter suspected to be liver invasion, a right atrial and inferior vena cava (IVC) tumor thrombus with obstruction of hepatic vein junction of IVC, and small lung metastases. She was diagnosed with cT4N0M1 adrenocortical carcinoma (ACC) by a needle biopsy and radiographic examination. Right adrenalectomy and thrombectomy were successfully performed without cardiac arrest and without liver dissection. The operative time was 485 minutes, and the estimated blood loss was 7, 533 ml. No major peri- or postoperative complications were observed. For the residual lung mass, a first line combination chemotherapy with etoposide, doxorubicin, cisplatin and mitotane followed by a second line chemotherapy with gemcitabine and capecitabine were administered. She has been alive with disease for 45 months under mitotane treatment against residual lung metastases. In conclusion, extended surgery could be successfully performed for advanced ACC with right atrium and IVC tumor thrombus. Although careful planning is needed for successful surgery, combination therapy with extended surgery and subsequent systematic chemotherapy may provide a substantial benefit in patients with advanced ACC.
Rights: 許諾条件により本文は2020/11/01に公開
DOI: 10.14989/ActaUrolJap_65_10_397
PubMed ID: 31697884
Appears in Collections:Vol.65 No.10

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