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Abstract
症例は79歳,男性. 2004年1月11日より全身倦怠感,発熱出現.既往歴はS状結腸癌.近医CTで左後腹膜腔に腫瘤あり.当院外科に紹介受診.腹部エコーは低エコーの腫瘤.CTは内部均一,軽度造影効果のある腫瘍. MRIはT1強調画像で高信号, T2強調画像で低信号から等信号であった.血管造影施行し,左腎上前区動脈を栄養動脈とする左後腹膜腫瘍の診断. 3月10日紹介で当科初診.後腹膜腫瘍の診断で, 3月22日左腎と共に腫瘍摘出術施行.摘出標本は大きさ21×18×7cm,重さ1,100gであった.病理組織診断はstoriform-pleomorphic typeの悪性線維性組織球腫.術後11ヵ月目のCTで左後腹膜腔再発を認め,放射線治療(45Gy)を施行した. 12月20日多発性肺転移及び多発性骨転移のため永眠された.本邦報告された腎周囲組織発生のMFHは10例と比較的稀であった.
A 79-year-old man who had low grade fever and general malaise was referred to our hospital on January 27, 2004. Physical examination revealed a hard fixed painless mass, measuring 10 cm in the left abdomen. Sarcoma of retroperitoneal origin was suspected preoperatively by abdominal ultra-sonogram, CT, MRI and Angiography. Extended surgical treatment including left nephrectomy was performed. The tumor was histologically diagnosed as storiform-pleomorphic malignant fibrous histiocytoma (MFH) arising from perirenal tissue. Although we recommended adjuvant therapy after the excision, the patient refused. After a follow-up period of 11 months, he developed local recurrence in the left retroperitoneal space, and external irradiation was performed. He died 21 months after the operation. To our knowledge, this is the 10th case of MFH arising from perirenal tissue in Japan.
Journal
- The Japanese Journal of Urology [List of Volumes]
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The Japanese Journal of Urology 98(4), 638-642, 2007-05-20 [Table of Contents]
The Japanese Urological Association
