下大静脈に腫瘍栓を伴った肺癌副腎転移の1切除例

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  • A CASE REPORT OF ADRENAL MATASTASIS OF LUNG CANCER WITH VENA CAVAL THROMBUS

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We experienced a resected case of adrenal metastasis of lung cancer with vena caval thrombus. A 65-year-old man who underwent lobectomy of the right middle and inferior lobes for an adenosquamous cell carcinoma of the lung 2 years before was seen at the hospital because of edema of the bilateral lower extremities. Computerized tomography (CT) of the abdomen showed a large mass measuring 6cm in the area of the left adrenal gland with the left renal vein thrombus extending into the inferior vena cava. Left nephrectomy, left adrenalectomy, and inferior vena cava thorombectomy through vena caval incision were performed under partial extracorporeal circulation. The histological feature was similar to the previous lung focus and it was consistent with metastatic adenosquamous cell carcinoma. However, immunohistochemical studies suggested the only metastatic tissue produced α-fetoprotien. Three months later CT revealed an evidence of hepatic matastases with portal vein thrombus. It is considered that the tumor cell in the metastatic focus might have a different biological property to invade the vessels, compared to that of the original lung focus in this case. We would have to explor the biological function of cells for the metastatic focus to assess the prognosis.

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