馬蹄鉄腎に発生した腎血管筋脂肪腫の1例

Abstract

52歳女性。患者は乳癌術後観察中のCTにて左腎上極の腫瘤が指摘され, 著者らの施設ヘ紹介となった。臨床検査では異常所見は認められず, 腹部CT・MRIにより馬蹄鉄腎に発生した左腎細胞癌が疑われた。腎部分切除術を行なった結果, 病理組織学的に腫瘍は腎血管筋脂肪腫と診断され, 術後は経過良好であった。

The patient was 52 years old. She had undergone a breast cancer operation 4 years before this visit. On computed tomography (CT), a left renal tumor in a horseshoe kidney was incidentally pointed out. CT scan showed a 1.8-cm enhanced tumor in the upper pole of the left kidney. It was hyperechoic on ultrasonography. Since renal cell carcinoma could not be excluded preoperatively, left partial nephrectomy was performed. Pathological diagnosis was a renal angiomyolipoma. The incidence of horseshoe kidney is 1 in 400. The occurrence of hydronephrosis, infection and calculous disease is not uncommon. However, a case of angiomyolipoma simultaneously with a horseshoe kidney is very rare, this being the 7th case in the literature.