尿管切石術中に偶然に発見した腎細胞癌の1例

A CASE OF SMALL CELL CARCINOMA FOUND DURING THE URETEROLITHOTOMY

緒言

　腎悪性腫瘍はすべての臓器癌の1〜2％を占め，そのうち，腎細胞癌が83.4％を占めると言われている^1）。腎細胞癌に結石が合併することは少なく，本邦において自験例が40例目にあたり，しかも切石術中に偶然に発見された示指頭大以下の小腎細胞癌は非常に稀で，本邦では4例目になる。術中に小腎腫瘍を偶然に発見した場合，腎摘出すべきか，それとも腎部分切除など保存的手術を施行すべきかについて考察を行つた。

In a forty seven years old male, who had the left ureter stone with left flank colicky pain, macro-hematuria and vomiting, left ureterolithotomy was done and we discovered the finger-tip sized tumor at the middle portion of the posterior aspect of the kidney by chance during the operation and resected the tumor. We did the nephrectomy on the seventh postoperative day because the tumor was diagnosed as clear cell carcinoma. The patient is well for four years after the operation without recurrence or metastasis. We discussed the indication of the conservative surgery for a small renal tumor.