神経芽細胞腫を合併したWilms腫瘍の1例

A CASE OF WILMS' TUMOR WITH NEUROBLASTOMA

　今回われわれは，交感神経母細胞腫を合併したWilms腫瘍の1例を経験したので報告する。患者は左側腹部腫瘤を主訴とした6歳の男子。IVPと腎CTで左Wilms腫瘍と診断し，尿中ドーパミンとノルアドレナリンの異常高値の原因が不明のまま，左腎の摘出とリンパ節郭清を行つた。腎茎部下方の傍大動脈のリンパ節と思われた腫瘤は，病理学的に交感神経母細胞腫であり，術後尿中カテコーラミンも正常化し，放射線療法と化学療法（actinomycin-D, vincristine）を行い，4年後の現在，再発もなく順調に経過している。

A 6 year old boy was admitted to our hospital to examine a left abdominal tumor. Urological work up, which included an intravenous pyelography and a CT scan demonstrated a space occupying lesion in the left kidney, suggestive of a left Wilms' tumor. Laboratory data on admission revealed high level of catecholamines in the urine. An operation was performed through a thoraco-abdominal appro-ach, and the tumor originated from the left kidney was radically removed. Para-aortic lymph nodes were also resected at the sametime. A pathologic finding was a typical nephroblastoma.