α-フェトプロテイン産生副腎肝様癌の1例

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57歳男に発生した左副腎原発肝様癌。術前の血中AFPとPIVKA-2は異常高値を示したが,術後完全に正常化したA case of left adrenal hepatoid carcinoma is reported. The patient was a 57-year-old male and his chief complaint was general fatigue. Preoperative laboratory data showed markedly increased levels of alpha-fetoprotein (AFP) (30,500 ng/ml) and PIVKA-II (3.01 AU/ml). Both computed tomography (CT) and magnetic resonance computed tomography (MRCT) showed left adrenal tumor (8 x 5 cm). Angiography showed hypervascular tumor over the upper pole of the left kidney. Thoracoabdominal nephro-adrenalectomy was performed. Histological examination demonstrated hepatoid carcinoma of the left adrenal gland. AFP was positive in the tumor cells. The levels of both AFP and PIVKA-II dropped to the normal range postoperatively. Hepatoid carcinoma in the urological field is very rare. As hepatoid carcinoma in the Japanese literature in the urological field, there were only 4 cases of renal tumor, 2 cases of renal pelvic tumor, 2 cases of retroperitoneal space and 1 case of urachal tumor. This is the first report of adrenal hepatoid carcinoma in Japan.