腎外傷を契機に発見された腎細胞癌

RENAL CELL CARCINOMA DIAGNOSED AT A FLANK INJURY

　73歳，女性．転倒し，右側腹部を打撲した．2日後，肉眼的血尿が生じた．腎外傷の疑いで直ちにCTを施行したところ，右腎腫瘍が発見された．経腹膜的右根治的腎摘出術を施行した．病理組織学的には腎細胞癌だった．腹部外傷ではCTが第一に施行されるべき検査法であるといわれている．本症例の経験から，腎外傷の画像診断には直ちにCTを実施すべきであると考える．

A 73-year-old woman had her right flank injured when she fell down and developed painless gross hematuria 2 days later. Physical examination showed muscle rigidity and tenderness in the right flank. Immediate CT revealed a mass involving the right kidney. Ultrasonography and angiography confirmed the diagnosis of renal tumor. The patient underwent successfull nephrectomy. Histology was renal cell car-cinoma. Some investigators state that CT is the first-choice diagnostic procedure in abdominal trauma. Experience of this case supports this view.