塞栓術で長期生存している自然破裂腎細胞癌

A LONG-TERM SURVIVING CASE OF SPONTANEOUSLY RUPTURED RENAL CELL CARCINOMA TREATED BY PERMANENT RENAL ARTERIAL EMBOLIZATION

　59歳，女性。主訴は右側腹部痛と血尿。右腎腫瘍の自然破裂と診断し，腎摘出術を試みたが，被膜下に巨大血腫を形成し周囲との癒着強固なため摘出不能で，生検および血腫の除去のみ行った。組織学的には腎細胞癌明細胞型であった。1ヵ月後主要動脈起始部にて金属コイルによる永久的動脈塞栓術を行った。その後腫瘍は縮小し，約9年を経た現在経過良好である。

The patient was a 59-year-old woman, who had been suffering from the right flank pain and hematuria. Preoperative diagnosis was the right renal tumor with spontaneous rupture. Nephrectomy was attempted, but the tumor could not be removed because of strong adhesion and large subcapsular hematoma, therefore only removal of hematoma and biopsy were done. The histopathological diagnosis was renal cell carcinoma of the clear cell type. One month later, permanent embolization was perfo-rmed with a metal coil.