腎被膜原発血管脂肪腫の1例 [in Japanese] A CASE REPORT OF ANGIOMYOLIPOMA ARISING FROM THE RENAL CAPSULE [in Japanese]
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腎被膜原発の血管筋脂肪腫を経験したので報告する. 49歳女性. 検診での超音波検査で直径10cm大の腹部腫瘤を指摘され当科を初診. 腹部造影CT上, 左腎後方に被膜のみ造影される同大の腫瘍を認め, 内部に数ヵ所の隔壁を有していた. MRIでは腫瘍内に出血を認め, 選択的腎動脈造影では腫瘍は腎被膜動脈よりの栄養血管を得ていた. 腎被膜原発腫瘍の術前診断にて開復術施行しだが, 術中迅速標本にて悪性が疑われたため, 根治的左腎摘除術を施行した. 最終的には血管筋脂肪腫の病理診断を得た. 腎被膜腫瘍は比較的稀であり, さらに腎被膜原発の血管筋脂肪腫は極めて稀である. われわれが調べた範囲では本邦で2例の報告例をみるのみである.
A case of angiomyolipoma arising from the renal capsule is reported. A 49-year-old female was admitted to our hospital with a complaint of abdominal mass pointed out by ultrasonography during her yearly health check. The tumor was 10cm in size. On abdominal enhanced CT, the tumor was existed behind the left kidney. The capsule of the tumor was enhanced and the septums were seen inside of the tumor. MRI revealed a hemorrhage in the tumor and selective renal angiography showed the tumor was fed by the renal capsular artery.<br>A tumor of the renal capsule was suspected and a laparotomy was done. Pathological results by the frozen section suggested malignancy and radical nephrectomy was performed.<br>Angiomyolipoma was diagnosed histologically. Tumors of the renal capsule are uncommon and angiomyolipoma of the renal capsule is extremely rare. We have found only two cases in Japanese medical literature.
- The Japanese Journal of Urology
The Japanese Journal of Urology 88(11), 961-964, 1997-11-20
The Japanese Urological Association