自然破裂を来たした肝細胞癌腎転移の1例

Abstract

TA 51-year-old Japanese man presented with a history of percutaneous transhepatic portal veinembolization, right hepatic lobectomy for hepatocellular carcinoma, and left upper pulmonary lobectomy forpulmonary metastasis of hepatocellular carcinoma. Owing to the elevated tumor marker levels, ultrasonography and fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PETCT) were performed, which revealed a left renal tumor 24 mm in diameter with FDG accumulation ;accordingly, renal metastasis of hepatocellular carcinoma was diagnosed. Localized radiofrequencyablation (RFA) was scheduled due to the absence of metastases other than that in the left kidney. The tumorcould not be effectively visualized using ultrasonography immediately before RFA ; therefore, a CT scan wasperformed. CT revealed a hematoma around the left kidney resulting from the spontaneous rupture of a leftrenal tumor ; consequently, RFA was discontinued. A left nephrectomy was performed for radicaltreatment of the left renal tumor. The pathological diagnosis of the resected specimen was left renalmetastasis of hepatocellular carcinoma. This is the third reported case in Japan of spontaneous rupture of ametastatic renal tumor from hepatocellular carcinoma.