腸重積を来した淡明細胞型腎細胞癌の小腸転移

Intussusception due to renal cell carcinoma with small intestine metastasis : A case report

　53歳女性．右腎細胞癌に対し腎摘出術後，5年7か月経過していた．肺転移に対し分子標的薬を使用中，腹痛と粘血便が出現し，上部消化管・大腸内視鏡検査を施行されたが，異常は認められなかった．腹痛が頻回になり，救急外来を受診したところ，CTで小腸腫瘍による腸重積が認められ，小腸部分切除術を施行した．病理診断は腎細胞癌の小腸転移であった．

Abstract

We report an uncommon case of small bowel metastasis secondary to renal cell carcinoma causing intussusception in a 53 year-old woman. The patient had a right nephrectomy because of renal cell carcinoma (Clear cell, G2, T3bN0M1) five years prior to the current admission. Postoperative molecular targeted therapy had continued for lung metastases. She presented with abdominal pain and mucous and bloody stool. Although upper gastrointestinal endoscopy and colonoscopy were performed, no abnormal findings were detected. Two months later, she suffered severe lower abdominal pain. CT scan showed that multiple dilated small bowel loops and an enhanced mass with the ‘target’ sign in the pelvis. Therefore, we made a diagnosis of intussusception caused by small intestine tumor. Partial enterectomy was performed immediately, and histopathological examination revealed renal cell carcinoma metastasis (Rinsho Hinyokika 70 : 459-462, 2016).