腎腫瘍が疑われた後腹膜粘液性嚢胞腺癌の1例

A CASE OF RETOROPERITONEAL MUCINOUS CYSTADENOCARCINOMA:SIMULATING RENAL TUMOR

　62歳，女性．右側腹部痛を主訴として来院．既往歴に両側卵巣嚢腫摘出術を30年前に受けていた．CT，磁気共鳴画像，超音波断層，血管造影が施行され，右腎下極に大きな嚢胞性腫瘤と左腎に小さな同様の腫瘤を認めた．右腎嚢胞穿刺を施行したところ，内容液は黄白色ゼリー状で，細胞診は陰性であった．周囲臓器との強い癒着と術中病理で悪性所見がみられたため，嚢胞性腫瘍は右腎と上行結腸とともに摘出された．組織学的診断は後腹膜粘液性嚢胞腺癌であった．調べ得た限りでは自験例を含め本邦では4例の報告がみられた．

A 62 year-old female with a past history of bilateral ovarian cyst which had been removed 30 years ago was hospitalized with the chief complaint of right abdominal pain. CT, MRI, ultrasonography and angiogra-phy revealed a large cystic mass at the lower pole of the right kidney and a small resemble density mass in the left kidney. When the cystic tumor was punctured, the contents of the cyst was yellowish jelly and the cytologic examination was negative. The cystic tumor was removed with the right kidney and ascending colon, because they were connected tightly with each other and frozen section was malignant.