右腎摘，部分切除後に再部分切除術を施行した再発性腎癌

A case of metachronous bilateral renal cell carcinoma treated with radical nephrectomy in one kidney and 2 partial nephrectomies in the other

症例は52歳，女性。2002年12月に右腎細胞癌に対し右根治的腎摘除術。2005年12月に左肺転移に対し左肺部分切除術。2008年5月に左腎細胞癌に対し，左腎部分切除術を施行。2008年11月にCTで左腎上極に10mm大の腫瘤を認め，画像診断にて再発を疑われた。2009年3月にCT再検で上記腫瘍のほかに左腎中-下極にも10mm大の腫瘤を認めたため，2009年4月に左腎部分切除術を施行した。計3個の腫瘍を摘出した。病理診断で，3個すべての腫瘍が腎細胞癌淡明細胞癌であった。

A 52-year-old woman underwent right radical nephrectomy for clear cell carcinoma in 2002 followed by partial lung resection for lung metastasis in 2005. She was first referred to our hospital in 2008. CT scan revealed a hypervascular mass in the left kidney,and a partial nephrectomy of the left kidney was performed. Local recurrence occurred 6 months after surgery and a second partial nephrectomy was performed in 2009 to avoid dialysis. The tumors were histologically identified as clear cell carcinoma. After surgery for bilateral renal cell carcinoma,the patient has been well without any nephrological problems.