右精巣静脈を経て下大静脈腫瘍血栓を形成した腎細胞癌

RENAL CELL CARCINOMA WITH INFERIOR VENA CAVAL EXTENSION VIR RIGHT SPERMATIC VEIN: A CASE REPORT

　73歳，男性．集団検診にて肺転移巣を指摘され受診．CTで右腎腫瘍を認め，血管撮影にて下大静脈腫瘍血栓を認めた．血栓摘除を含めた根治的腎摘除術を施行したところ，腫瘍血栓は右精巣静脈を経て下大静脈におよんでおり，右腎静脈は正常であった．病理組織結果は，右精巣静脈内腫瘍血栓をともなった腎細胞癌であった．腎細胞癌において，右精巣静脈を介した下大静脈血栓の例は，これまで文献上報告がなく，その発生機序について考察を行った．

A 73-year-old man was referred to us for evaluation of multiple coin lesions in the chest roentogenogram.Abdominal CT scan revealed a right renal mass with a infra-renal thrombus in the IVC. At operation, thethrombus extended through the right spermtic vein into the IVC, and the main right renal vein was free ofthrombus. Pathological diagnosis was right renal cell carcinoma with tumor thrombus in the right spermaticvein. To our knowledge this is the first report of renal cancer with vena caval extension via the rightspermatic vein.