腎平滑筋肉腫の2例
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概要
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Primary leiomyosarcoma of the kidney is a rare neoplasm. Only 47 cases have been reported in foreign countries according to the Niceta's report, and 22 cases in Japan. Two cases of primary leiomyosarcoma of the kidney were reported herein. Case 1 : A 31-year-old house wife was admitted because of left upper abdominal mass without pain. Laboratory findings were within normal limits. A left pyelogram showed shift, deviation and dilatation of calices. Aortograms showed space-occupying lesion with poor vascularity in the left kidney, as if like a giant cyst. According to these findings, this case was diagnosed as a solitary cyst of the left kidney. On operation, however, venous dilatations were so remarkable on the surface of the tumor that we thought it was a malignant tumor. The cyst contained bloody fluid by the exploratory puncture. Nephrectomy was done, because of these findings. Pathological examination, optic-microscopically and electron-microscopically, showed it was primary leiomyosarcoma of the kidney and the cyst-like findings were compatible with pseudocystic changes due to necrosis and bleeding. She was well at 19 months after nephrectomy, without signs of recurrence and metastasis. Case 2: A 24-year-old house-wife was admitted because of right flank pain and gross hematuria. Laboratory findings were within normal limits. A right pyelogram showed shift and deviation of the upper calices. Aortograms revealed pooling sign partially, but relatively poor vascularity. According to these findings, this case was diagnosed as right renal tumor. Nephrectomy was done. Pathological examination showed it was primary leiomyosarcoma of the kidney. She was readmitted 3 months after nephrectomy, because of right hypochondralgia. We thought that it was due to the localized recurrence of the tumor. She moved to another hospital one month after readmission, and was lost from our follow-up. A discussion was made on the characteristics of leiomyosarcoma of the kidney in reference to Japanese and foreign literatures.
- 泌尿器科紀要刊行会の論文
泌尿器科紀要刊行会 | 論文
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