食道癌の腎転移症例

概要

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A 65-year-old woman, who had undergone total esophagectomy for cancer one year prior to admission, noted asymptomatic gross hematuria. Therefore, she was referred to our department in July, 1983. Physical examination revealed a hard, irregular and nontender mass in the left upper abdomen. Excretory urography revealed a space-occupying lesion in the lower pole of the left kidney. Selective renal angiography revealed a hypovascular mass and encasement of the renal artery. Percutaneous renal artery embolization was performed two weeks prior to nephrectomy. At surgery, the left kidney was adhered to the surrounding tissue and it was hard to dissect. Paraaortic lymph nodes were swollen and a couple of them were biopsied. The histopathological report of the tumor was squamous cell carcinoma. The patient was treated with systemic chemotherapy, but the postoperative course was poor and the patient emaciated gradually. She did ten weeks after operation and autopsy was refused. Metastases of malignant tumor to the kidney are rarely encountered in clinical cases and, to our knowledge, this case seems to be the forth metastatic renal tumor from esophageal cancer in the Japanese literature.