腎癌術後経過観察中に局所再発と鑑別を要した脾症の2例

Abstract

65歳男性, 71歳男性。患者は腎癌根治的腎摘出術後8年目, 9年目のCTにて左横隔膜下の腫瘍を認めた。いずれも局所再発の可能性も考えられたが, 術中の脾損傷により脾臓摘出術が施行されていたため, 脾臓シンチグラフィーを行った結果, 脾症と確定診断された。

Splenosis is autotransplantation of splenic tissue and usually follow traumatic or surgical rupture of the spleen. We report two cases of splenosis which presented as a local recurrence after radical nephrectomy for left renal cell carcinoma (RCC). The patients were a 65- and a 71-year-old male, who had been operated for RCC including splenectomy because of disrupture of the splenic capsule 8 and 9 years earlier respectively. In both cases, follow up computed tomographic scans showed small nodules under the left diaphragm. Although we initially suspected local recurrence, we considered the possibility of splenosis. Both patients underwent technetium-99m Sn colloid scans and were diagnosed with splenosis successfully. Therefore, we could avoid unnecessary surgical explorations.