エリスロポエチン産生腎細胞癌の1例

A Case of erythropoietin-producing renal cell carcinoma

　症例は45歳，男性。3年前より高血圧にて加療中，1年ほど前より異常発汗，体熱感，全身倦怠感が出現した。精査にて赤血球増加症，血中エリスロポエチン（以下EPO）濃度の増加および左腎腫瘍を認めた。術前に合計1,200mlの瀉血ののち根治的腎摘除術を施行した。術後赤血球数および血中EPO濃度は正常化した。腫瘍部の組織内EPO濃度は正常部の約8.5倍であった。EPO産生腎細胞癌の報告は本邦で18例目である。

The patient was a 45-year-old male who had been treated for hypertension for the past three years. Abnor-mal sweating, a sensation of body heat and general fatigue developed about one year ago. Detailed investiga-tion revealed erythrocythemia, an increase of blood erythropoietin level and a tumor of the left kidney. Fol-lowing the preoperative withdrawal of a total of 1,200ml of blood, radical nephrectomy was performed. The post-operative red blood cell count and the blood erythro-poietin level was normalized. The erythropoietin con-centration within the tumor tissue was around 8.5 times higher than the normal tissue.