腎被膜に発生した血管肉腫の1例

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68歳男性.患者は右後腹膜腫瘍の精査加療目的に著者らの施設へ紹介入院となった.腹部超音波では右腎外側に低エコーの辺縁不整な腫瘍が認められ,腹部CTでは右腎外側と肝右葉を沿い,頭尾方向に約7cmにわたり不整形の細長い軟部腫瘤影が確認された.MRIではT1にて低信号,T2にて不均一な高信号を呈し,後期相では一部濃染がみられた.以上,これらの所見より,右腎被膜腫瘍を考え,経腰的に第12肋骨を切除し,右腎および腎被膜腫瘍摘出術を行なった.病理組織学的に腎被膜より発生した血管肉腫と診断され,術後は更に放射線照射を追加した.術後19ヵ月経過現在,再発や転移はみられていないWe report herein a case of renal capsular hemangiosarcoma. A 68-year-old man was admitted to our hospital for treatment of a retroperitoneal tumor identified incidentally on abdominal computed tomography (CT) for follow-up of superficial bladder tumor. The tumor was about 7cm in diameter, positioned between the right kidney and the liver. Right nephrectomy was performed under a diagnosis of renal capsular tumor. Pathological diagnosis was hemangiosarcoma and positive surgical margins were suspected. Radiotherapy was performed postoperatively to a total dose of 50 Gy. Hemangiosarcoma frequently occurs in the skin, but is rare in the retroperitoneal cavity. Neither metastasis nor recurrence has been seen as of 19 months postoperatively.

腎被膜に発生した血管肉腫の1例

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