Read/Search this Article
Abstract
症例は58歳女性,検診で左腎嚢胞を指摘され当科受診した.腹部CTにて左腎の水腎を伴う20×12×11cm大の腫瘍を認めた.血清CA19-9は4,400U/mlであった.左腎孟尿細胞診は陰性であり,術前に腫瘤か腎細胞癌か腎孟癌か確定できなかった.根冶的左腎摘除術時に迅速診断にて腎細胞癌と診断された.免疫組織化学染色にてCA19-9は腎孟粘膜に限局しており腫瘍細胞には含まれなかった.術後,CA19-9は正常域に下降した.CA19-9は尿路上皮癌で時に上昇することが知られているが腎細胞癌で上昇することは稀である.自験例では腫瘍の閉塞による水腎症が原因で上昇したものと考えられた.
A 58-year old female was referred to our hospital due to left renal cyst that was pointed out at her health check-up. Abdominal CT scan showed left hydronephrosis with a 20×12×11cm tumor. The serum CA19-9 level elevated to 4, 400U/ml. Urinary cytology in the left renal pelvis was negative, therefore we could not diagnose whether the mass was renal cell carcinoma or renal pelvic tumor before surgery. She underwent left radical nephrectomy, and frozen section revealed renal cell carcinoma. Immunohistological stain clarified CA19-9 was limited to epithelium lining the renal pelvis and was not contained in carcinoma cells. After the surgery, the serum CA19-9 decreased to the normal range. Serum CA19-9 is known to be sometimes elevated in patients with urothelial carcinoma, but rarely elevated in those with renal cell carcinoma. We thought that hydronephrosis by tumor occlusion caused CA19-9 elevation in our case.
Journal
- The Japanese Journal of Urology [List of Volumes]
-
The Japanese Journal of Urology 99(1), 39-42, 2008-01-20 [Table of Contents]
The Japanese Urological Association
