根治的腎摘除術後同側残存副腎組織及び対側副腎に転移をきたした腎細胞癌の1例

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68歳女.4年前右細胞癌にて根治的腎摘除術とインターフェロンαの投与を受けている.今回CTで右残存副腎組織及び左副腎転移と診断,両側副腎腫瘍を摘除した.左副腎腫瘍は60g,右副腎腫瘍は33.3gで,組織学的にそれぞれGrade 2相当の淡明型腎細胞癌の増生を認め,又,正常副腎組織も確認された.術後副腎皮質ホルモンの補充を行い,18ヵ月後の現在経過良好であるA 68-year-old woman had undergone radical nephrectomy via a transabdominal approach 4 years earlier for a 8 cm tumor located from the midportion to the upper pole of the right kidney. Pathological diagnosis was renal cell carcinoma (RCC), clear cell subtype, G2, pT2pN0M0. Four years postoperatively, followup computed tomography scan revealed masses in bilateral adrenal region (6 cm in diameter on the left side and 5 cm on the light). Bilateral adrenalectomy confirmed the diagnosis of adrenal metastases from clear cell carcinoma. It was concluded that the tumor had metastasized to the ipsilateral adrenal tissue as the residuum of the previous surgery. She has been treated by oral steroid supplementation without evidence of recurrence for 18 months.