小腸転移をきたした腎細胞癌

A case report of small intestine metastasis from renal cell carcinoma

45歳，男性。健診で腎腫瘍を指摘され，左腎摘出術施行。淡明細胞癌，pT3b N0M0，G2，V（＋）と診断された。インターフェロンを投与するも術後15か月で食欲不振および中等度の貧血が出現した。精査で小腸および肺転移と診断された。インターフェロン投与量の増量や変更をしたが，全身状態が悪化し，術後29か月目で死亡した。

Abstract We report a case of small intestine metastasis from renal cell carcinoma（RCC）in a 44-year-old man. The patient underwent left nephrectomy because of RCC（G2,T3b N0M0）. Postoperative interferon therapy was discontinued because he suffered from appetite loss and fever,15 months after the operation. A chest X-ray showed multiple lung metastases and CT scan revealed multiple lymph nodes and a large mass close to the pancreas that was not definitively diagnosed. A double balloon enteroscopy revealed intestinal tumor. The histological features of the tumor biopsy specimen confirmed the metastatic RCC. The patient's general condition became worse and he died 29 months after nephrectomy. To our knowledge,this is 26th case of small intestinal metastasis from RCC reported in the Japanese and English literature.