両側腎血管筋脂肪腫の保存経過観察の1例

A CASE OF BILATERAL RENAL ANGIOMYOLIPOMA UNDER CONSERVATIVE TREATMENT

緒言

　腎血管筋脂肪腫は本来良性であるが，大出血をおこし腎摘除されることがある。さらに，緊急でなくても，IVP所見や，血管像によつて腎癌との鑑別が困難であるために，腎が摘除され，摘出標本で診断されることが多い。

　本症の腎がすべて保存できるわけではないが，問題は腎癌の診断の下に腎摘除が行われることである。したがつて，正確な診断をつけることが急務となる。

A fourty seven year-old house wife was admitted for total gross hematuria and continuous severe right lumbago with slight fever. Clinical diagnosis was made by IVP films as bilateral renal tumors. Angiographic findings showed hypervascurality in both kidneys and an arterial dilatation in the right kidney. CT scanning films showed low density at the bilateral tumor-area with varied interspersed solid tissue density. Final diagnosis of angiomyolipoma was obtained by biopsy materials.

After succesful conservative treatment she was discharged with decreased serum LDH and bilirubin.