右心房腫瘍血栓を伴った腎細胞癌の摘除

A CASE OF RENAL CELL CARCINOMA WITH TUMOR THROMBOSIS TO RIGHT ATRIUM

　症例は58歳，男性。全身倦怠感を主訴に当院内科受診，腹部CT上，左腎腫瘍を指摘され当科に入院した。腹部MRIで下大静脈から右房につながる腫瘍血栓を認め，下大静脈造影で第2腰椎レベルから上方への下大静脈の完全閉塞および側副血行路の発達を認めた。以上から右心房腫瘍血栓を伴った左腎腫瘍と診断し腫瘍血栓除去および根治的左腎摘除術を施行した。1年5か月経った現在，再発および転移を認めていない。

A 58-year-old male with a chief complaint of general malaise visited our hospital. Abdominal CT and MRI revealed left renal tumor with tumor thrombosis from inferior vena cava (IVC) to right atrium, and inferior venacavography revealed total occlusion of IVC above the second lumbar vertebra level. Diagnosis of left renal tumor with tumor thrombus to right atrium, was made and successful resection of the tumor was performed by spiral incision through retroperitoneum. Histological diag-nosis was renal cell carcinoma. No evidence of recur-rence or metastasis is observed after 15 months follow up.