化学療法が著効したベリニ管癌

Bellini duct carcinoma which chemotherapy was remarkably effective

症例は27歳，女性。左鎖骨上リンパ節腫大を主訴に受診し，生検により転移性腺癌と診断された。PET-CTより，リンパ節，肺，骨に多発性転移を有する左腎癌と診断し，経腹膜的腎摘除術を施行した。病理組織検査でベリニ管癌と診断し，ゲムシタビンとカルボプラチンの併用療法を施行した。著明な抗腫瘍効果を認めたが，4コース終了後急激に全身状態が悪化し，死亡した。病理解剖による死因は心タンポナーデであった。

A 27-year-old woman visited a hospital with a chief complaint of left supraclavicular lymph node swelling. A needle biopsy was performed and histopathological finding showed metastatic adenocarcinoma. Positron-emission tomography CT（PET-CT）was performed and she was diagnosed as left renal cell carcinoma with metastatic lesions in lung,lymph nodes and bone. She was referred to our hospital and we performed left transperitoneal nephrectomy. Pathological examination showed bellini duct carcinoma of left kidney. Adjuvant chemotherapy consisted of carboplatin and gemcitabine was performed. PET-CT showed complete response in all of the metastatic lesions except left lung tumor. However,her general condition deteriorated rapidly and died in 2 months after the chemotherapy. An autopsy revealed that the cause of death was cardiac tamponade.