腎摘出後19年で副鼻腔に転移を認めた腎明細胞癌の1例

A case of metastatic clear cell carcinoma of the paranasal sinus in 19 years after nephrectomy

はじめに

　腎明細胞癌は血流に富んだ腫瘍であり，血行性に遠隔転移することが知られているが，副鼻腔への転移は稀である。今回われわれは，腎摘出後19年経過したのち副鼻腔に転移を認めた1例を経験したので，若干の文献的考察を交えて報告する。

　Renal clear cell carcinoma often metastasizes hematogenously, whereas it rarely metastasizes to the paranasal sinus. A 81-year-old man was diagnosed with renal clear cell carcinoma and underwent right nephrectomy in 1998. In 2017, he complained of right nasal bleeding. CT and MRI showed a large mass extending to the right nasal cavity and maxillary paranasal sinus. Positron emission tomography-computed tomography indicated a malignant tumor. Endoscopic sinus surgery was performed. Based on the results of immunohistochemical examination, we made the diagnosis of metastatic renal clear cell carcinoma. Temsirolims was selected for treatment.