肺癌の副腎転移の1例 [in Japanese] A RESECTED CASE OF METASTATIC ADRENAL TUMOR FROM A LUNG CNACER [in Japanese]
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転移性副腎腫瘍は,剖検例では比較的高頻度に認められるが,臨床的に切除された例は稀である.今回,肺癌の孤立性転移と考えられた副腎腫瘍を切除しえた症例を経験したので報告する.症例は63歳男性,肺癌で平成7年4月に左肺下葉切除を施行した.組織型は高分化型腺癌でt2n0M0, Stage IIであった.術後7カ月後, CEA値の上昇と共にCTで左副腎腫瘍が指摘された.肺癌の孤立性転移と診断し,左副腎摘出術を施行した.病理組織学的に肺腺癌の副腎転移で,術後2週目よりCDDP, MMC, VDS併用療法を1クール施行し,術後42日目に退院した.肺癌副腎転移巣を切除しえた本邦報告例は自験例が13例目であった.自験例は転移巣切除後1年経過した現在再発の徴候なく健在である.副腎転移でも孤立性であれば積極的に切除すべきである.
Metastatic adrenal tumors are found in a high incidence at autopsy, but are rarely resectable clinically. A resected case of metastatic adrenal tumor from a lung cancer is reported. A 63-year-old man, who had been operated on for an adenocarcinoma of the lung 7 month before was pointed out having a left adrenal tumor on computed tomography (CT). Hematological examination showed a high CEA level of 46.2ng/ml.<br> CT, abdominal ultrasonography, and magnetic resonance imaging (MRI) showed a left metastatic adrenal tumor from the lung cancer (well differentiated adenocarcinoma; t2n0M0 in stage II). The tumor was successfully resected. The adrenal tumor was confirmed a metastasis from the lung cancer by pathological examination. The postoperative course was uneventful and he had been treated by chemotherapy with CDDP, MMC and VDS from 14th post operative day. He was dischargd as cured on 42nd postoperative day.<br> Recentable metastatic adrenal cancer from lung cancer has been reported in only 13 cases in Japan including the present case. The metastatic adrenal tumor should be excised when the adrenal metastasis is solitary and the primary lesion is well-controlled.
- Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 59(4), 957-961, 1998-04-25
Japan Surgical Association