腎癌の海綿静脈洞転移の1例

A CASE OF RENAL CELL CARCINOMA WITH METASTASIS TO THE CAVERNOUS SINUS

　56歳，主婦．肉眼的血尿を主訴に他医受診．右腎癌の診断で右腎摘出術を受けた．術後肺転移をきたし免疫療法を受けたが，転移増大のため当科に紹介された．当科治療中急に左偏頭痛・左眼瞼下垂をきたした．原因検索の結果，MRIにて左海綿静脈洞転移を認め，これによる左動眼神経麻痺と診断した．同転移に対し放射線療法を行い局所所見と症状は改善した．悪性腫瘍の海綿静脈洞遠隔転移は，本邦文献上では自験例は12例目にあたる．

A 56-year-old female with a history of macroscopic hematuria, was diagnosed as right renal tumor and underwent right nephrectomy. Clear cell carcinoma was histopathologically recognized. Several metastases to both lung fields developed in spite of postoperative immunotherapy. Six months later, she experienced left temporal headache and drooping of the left eyelid. Neurological examination showed complete left 3 rd cranial nerve palsy without palsy of 6 th nerve. Head MRI revealed a mass involving the cavernous sinus. From these findings a diagnosis of metastasis to the left cavernous sinus due to the renal cell carcinoma was made.