肺癌腎転移の1例

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2年前に肺腺癌で外科治療を受けた45歳主婦で,追跡CTで左腎腫瘍が指摘された.7ヵ月間の観察中に最大直径は1cmから3cmに増大した.倍増時間が40日と短い事は腫瘍が転移性であることを示唆したが,腹部超音波検査,血管造影,及びCTは原発腎細胞癌を除外しなかった.左腎摘除を行った.組織学的に肺腺癌の転移と診断された.術後13ヵ月に肺再発を持ち生存しているA 45-year-old house-wife, who had undergone surgical treatment for lung adenocarcinoma 2 years previously, presented with a left renal mass detected by follow-up CT. During 7 months of observation, it rapidly enlarged from 1 cm to 3 cm in maximum diameter. Although the short doubling time (40 days) suggested that the tumor was metastatic, abdominal urtrasonography, angiography and CT scan did not exclude primary renal cell carcinoma. Left nephrectomy was performed. Histologically, the tumor proved to be metastasis from the previous lung adenocarcinoma. She has been alive with pulmonary recurrence 13 months after nephrectomy. The doubling time of the tumor may be one of the key factors in differentiating a metastatic renal tumor from a primary carcinoma.