下大静脈腫瘍塞栓を伴った腎血管筋脂肪腫の1例. (Japanese)

A 55-year-old woman had a small mass of the right kidney pointed out in 2014, and she then visited our hospital. Computed tomography showed a right renal tumor (17 mm in diameter) presenting equal density to normal fat tissue, and accordingly she was diagnosed with angiomyolipoma of the right kidney. She was recommended to undergo a periodic examination once a year, however, she did not attend any further examinations after that. In 2018, a right renal tumor was pointed out at a medical check-up, and she again came to our hospital. Computed tomography revealed a right renal tumor that had grown to 65mm in diameter and that had formed a tumor thrombus extending in to the inferior vena cava. The patient underwent right nephrectomy and extraction of the tumor thrombus. Pathological diagnosis was angiomyolipoma of the right kidney with no evidence of malignancy. No signs of recurrence or metastasis have been observed since the operation. [ABSTRACT FROM AUTHOR]

症例は 55 歳，女性。2014 年に検診で右腎血管筋脂肪腫を指摘され当科紹介受診。最大径 17 mm の右腎 血管筋脂肪腫を確認し 1 年毎に CT で経過観察の方針となっていたがその後再来はなかった。2018 年に検 診で右腎腫瘍を再指摘され当科紹介となった。CT で下大静脈塞栓を伴う最大径 65 mm の右腎血管筋脂肪 腫を認めた。術前に一時的下大静脈フィルターを挿入し開放右腎摘除術および腫瘍塞栓摘出術を行った。 腫瘍は周囲との癒着はなく下大静脈切開を行い右腎および腫瘍塞栓を一塊に摘出した。本症例は 4 年の経 過で 17 mm の右腎血管筋脂肪腫が 65 mm に増大し下大静脈まで到達する腫瘍塞栓が出現した。腎血管筋 脂肪腫における定期経過観察の重要性が再認識された。 [ABSTRACT FROM AUTHOR]

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