著明な石灰化を伴う腎細胞癌の1例

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症例:73歳女.無症候性肉眼的血尿を主訴とした.画像診断では左腎に一致して著明な石灰化像を認めた.超音波では左腎盂から腎下極にかけて6cm大の石灰下像を認めた.造影CTでは石灰化像に混在して弱い造影効果を認める腫瘤を認めた.選択的左腎動脈造影では腎動脈枝は腫瘤により変位していた.左腎細胞癌の診断のもと,経腰的根治的腎摘除術を施行した.病理組織では石灰化巣の中に腎細胞癌の腫瘍細胞集団を認めた.grade 2,INFα,pT2pN0pM0,stage IIと診断されたA 73-year-old woman visited another hospital with complaints of occasional episodes of gross hematuria. A computed tomographic (CT) scan revealed extensive calcification in the left kidney, and she was referred to our hospital for further examinations. The physical examination was unremarkable other than mild back pain on her left side. Blood chemistry was normal. The CT scan revealed a mildly enhanced tumor of 6 cm in diameter accompanied by extensive calcification in the left kidney. Angiography revealed a hypovascular tumor in the left kidney. A left radical nephrectomy was carried out. Gross appearance of the specimen showed extensive calcification from the renal pelvic to the parenchyma of the lower pole of the left kidney. The histopathological diagnosis was renal cell carcinoma, alveolar type, mixed subtype, pT2pN0pM0.