自然破裂をきたした成人型Wilms腫瘍の1例

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  • A CASE OF SPONTANEOUS RUPTURE OF ADULT WILMS TUMOR

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This paper describes an experience with a case of spontaneous rupture of adult Wilms tumor presenting with acute abdomen.<br> A 44-year-old woman had a sudden epigastric pain and felt a painful tumor in the right hypochondrial region. Hepatic cancer was suspected and the patient was admitted to the hospital. Abdominal echogra-phy and CT revealed a giant tumor with heterogenous and mosaic internal component at the same region as the right kidney is located, with a portion of the tumor extending into Winslow's foramen. In several hours thereafter anemia progressed and blood was aspirated by abdominal puncture. So emergency DSA was performed. Although a hypovascular tumor was confirmed in the lower part of the right kidney, no clear outflow of radiological medium was observed. The most probable diagnosis was ruptured renal cancer. An emergency operation was carried out. Right nephrectomy and complete removal of tumor massess disseminated in the abdomen was carried out. Histologically the excised renal tumor was diagnosed with adult Wilms tumor.<br> Wilms tumors are rare in adults, especially spontaneously rutptured tumor. Only two cases have been seen in the literature so far.

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