腎細胞癌の膣転移

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We wish to report a case of renal cell carcinoma which metastasized to the vagina, and studied the metastatic route of renal cell carcinoma to the vagina. A 22-year-old woman was admitted to our hospital on August 12, 1976 with chief complaints of epigastric pain, nausea and vomiting. She also complained of pain in the lumbar area. On examination, a palpable mass in the left flank was observed but microscopic pictures showed no hematuria. On the basis of excretion urography and renal angiography, she was diagnosed as having left renal cell carcinoma. Renal venography revealed a tumor embolism from the renal vein to the inferior vena cava, and X-ray film examination of the chest indicated a metastasis of tumors to the bilateral hilus lymph nodes. In spite of radiationtherapy and chemotherapy, tumors were not reduced in size. Five months later, in January 1977, vaginal bleeding occurred. A tumor more than the size of the tip of the thumb was found at the positions of 2 and 10 o'clock near the vaginal introitus, and also found a small egg-sized tumor at the left vaginal wall adjacent to the uterine neck. Histological examination of the vaginal lesions showed a clear cell adenocarcinoma abundant in the capillaries, and she was diagnosed as having a metatasis from renal cell carcinoma. The patient died on June 11, 1977. Autopsy was refused. We studied, in adult mongrel dogs, collateral circulation when the renal vein was ligated, by means of venography and autopsy, and blood flow of the ovarian vein before and after the left renal vein was ligated. The main collateral veins after ligation of the left renal vein were the ovarian vein and the ureteral vein, both of which passed on the route. On the other hand, in the right kidney, it was observed that the renal capsular veins passed to the ovarian vein after being anastomosed to the ureteral vein. The blood circulation of the left ovarian vein before the left renal vein was ligated was at a rate of 36ml/min from the ovary toward the renal vein, but the blood circulation began to flow, in the opposite direction, toward the ovary concurrently with the ligation of the renal vein, and 1 minute later, the flow rate came to 78 ml/min.

腎細胞癌の膣転移

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