下大静脈浸潤が疑われた後腹膜平滑筋肉腫

Retroperitoneal Leiomyosarcoma Suspected of lnvading the lnferior Vena Cava

　症例は69歳，女性。主訴は頻尿。腹部超音波検査にて右後腹膜腫瘍を指摘され，CTでは腎の上方に下大静脈を著明に圧排する腫瘍が認められた。内分泌学的検査では異常は認めなかったが，下大静脈浸潤を伴う右副腎癌と診断し，腫瘍および右腎，右副腎，下大静脈の一部を合併切除した。組織学的には後腹膜腔に発生した平滑筋肉腫と診断され，他臓器への腫瘍の浸潤は認められなかったため，術後補助療法は施行していない。

A 69-year-old woman complaining of pollakisuria wasreferred to our hospital for retroperitoneal tumor revealedwith ultrasonography. Abdominal computed tomographyshowed a low density tumor over the right kidney and theinferior vena cava (IVC) was remarkably compressed, Suggesting the invasion to IVC by the tumor. On arteriog-raphy, it was hypervascular and was fed by the middle andlower adrenal arteries. Inferior venacavography showedremarkably compressed of IVC by the tumor. Althoughhormonal examination showed normal, the right adrenamadenocarcinoma was suspected.