発熱を主症状としStauffer's症候群を呈した肉腫様腎癌

Sarcomatoid renal cell carcinoma accompanied by high fever and Stauffer's syndrome：A case report

　肉腫様腎癌は腎細胞癌の亜型であり，悪性度が高く急速に進行し予後が不良であることが知られている。今回われわれは，38℃以上の高熱を主訴とした肉腫様腎癌の1例を経験した。本症例は感染性疾患や不明熱の原因となる疾患の鑑別のため検査に時間を要し，腎臓摘出時には転移が広がってしまっていた。術後も転移巣からのparaneoplastic syndromeのため発熱やDICなどの症状が改善せず，最終的にStauffer's症候群を呈して永眠した。

A 54-year-old febrile man with the diagnosis of sarcomatoid renal cell carcinoma showing an aggressive clinical course was described. As he had a low enhanced area in his right kidney and right renal pelvic stone, it was difficult to diagnose its area as malignant tumor or infectious disease. Antibiotics were not effective and gradually he developed DIC and his general condition became worse. Finally, we did right nephrectomy and diagnosis of as sarcomatoid renal cell carcinoma was obtained using immunohistochemical study by cytokeratin and vimentin. He terminally fell into Stauffer's syndrome due to cytokines produced from metastatic lesions and died of multiple organ failure fifteen days after operation.