悪性褐色細胞腫の1例

A CASE OF MALIGNANT PHEOCHROMOCYTOMA

　68歳，男性。左副腎原発の褐色細胞腫の診断で左副腎腫瘍摘除術を施行したが，腫瘍は周囲組織，特に左腎との癒着が強くこれら組織とともに一塊にして摘除した。MIBGスキャンを含めた術前検査では，明らかな転移巣は認められなかったものの，摘除標本の組織学的検索にて腎周囲脂肪組織，腎門部血管，およびリンパ管への浸潤性発育が認められ，また細胞分裂像も著明であったため悪性褐色細胞腫と診断した。

A 68-year-old male patient, who was clinically diagnosed as pheochromocytoma of the left adrenal gland with no distant metastasis, underwent left adrenarectomy. The tumor was removed en bloc with the left kidney because of dense adhesions to the surrounding tissues especially to the left kidney. The diagnosis of malignant pheochromocytoma was made histologically. This was based on the findings of the surgical specimen, which showed many anaplastic cells in mitosis and a prominent infiltration into the surrounding fatty tissue, vascular pedicle, and lymphatics of the left kidney.