腎細胞癌摘出不能例の検討

FIVE CASES OF UNRESECTABLE RENAL CELL CARCINOMA DUE TO LOCAL EXTENSION

　腎細胞癌は一般には腫瘍被膜（偽膜）を形成しながら成長するものが多く，かなり大きな腫瘍にもかかわらず意外に簡単に摘出できてしまうものがあり，周囲への浸潤が少ない腫瘍という印象がある。更に近年，経胸腹的および経腹膜的手術の発展に伴い，腎細胞癌が技術的に摘出不能であるという場合は稀であるといわれている。腎細胞癌の経験の少なかつた頃は，著者らも同意見であつたが，最近いくつかの摘出不能例を経験し，それほど稀でないという実感を持ち，その頻度，摘出不能の原因，術前に判明できなかつた反省など述べてみたい。

It has been generally thought that renal cell carcinoma is usually resectable because its local extension is rare even in a large tumor. We have experienced 180 cases with renal cell carcinoma of which 151 received operations. Nephrectomy was successfully performed in 146 cases, but in the remai-ning 5 cases (3. 3%) only exploratory laparotomy was done because of extensive local infiltration. These five cases were presented and analysed.

Case 1 was inoperable because the tumor had grown on the superior pole of the right kidney invading the liver.