腎嚢胞と鑑別が困難であった石灰化腎細胞癌

A CASE OF RENAL CELL CARCINOMA DIFFICULT TO DIFFERENTIATE FROM CALCIFIED RENAL CYST

　53歳男性。主訴，腹痛。KUB上，右腎上極に直径約6cmの球形の石灰化像を認めた。CT上，石灰化した腎嚢胞が疑われたが，充実性の部分を伴い，腎細胞癌も否定できず腎摘出術を行った。病理学的には充実性部分に腎細胞癌を認めた。石灰化を伴う腎癌は硝子変性をきたしている場合が多く，術中病理診断では腎癌を同定できない場合がある。中心が均一で石灰化が周囲に限局している症例以外は腎癌に準じた治療を施行するべきだと考えられた。

A 53-year-old male was seen at this hospital with the chief complaint of abdominal pain. KUB revealed a spheric calcification about 6cm in diameter at the upper pole of the right kidney. On CT renal cell carcinoma was not ruled out, so nephrectomy was performed. Path-ologically, renal cell carcinoma was recognized. Renal cell carcinoma with calcification is frequently associated with hyaline degeneration, therefore cannot be identified by intraoperative pathological diagnosis in some cases.