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英文誌(2004-)

Journal of Medical Ultrasonics

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1997 - Vol.24

Vol.24 No.02

Case Report(症例報告)

(0157 - 0163)

腹部超音波検査が有用であった尿膜管癌と腎細胞癌の重複癌の1例

A Case of Double Cancer Comprising Urachal Adenocarcinoma and Renal Cell Carcinoma Assessed by Ultrasonography

井上 好子1, 大井 博通2, 亀岡 博3, 小角 幸人4, 新名 正己1, 小椋 直人1, 藤本 博久1, 田畑 勉5

Yoshiko INOUE1, Hiromichi OI2, Hiroshi KAMEOKA3, Yukito KOKADO4, Masami SHINMEI1, Naoto OGURA1, Hirohisa FUJIMOTO1, Tutomu TABATA5

1(蒼) 井上病院臨床検査部, 2大阪逓信病院放射線科, 3(蒼) 井上病院泌尿器科, 4大阪大学付属病院泌尿器科, 5(蒼) 井上病院内科

1Clinical Laboratory Department, Inoue Hospital, 2Department of Radiology, NTT Osaka Teishin Hospital, 3Department of Urology, Inoue Hospital, 4Department of Urology, Osaka University School of Medicine, 5Department of Internal Medicine, Inoue Hospital

キーワード : Double cancer, Ultrasound diagnosis, Renal cell carcinoma, Urachal carcinoma

A 43-year-old man presented gross hematuria and abdominal pain in the suprapubic region. Physical examination uncovered no abnormalities, and all but one of the laboratory values were within their normal ranges; CEA was 2.6 ng/ml. Urinalysis showed microscopic hematuria, and cytology was class Ⅲa. Ultrasonography showed an irregular mixed echo mass 10 cm in diameter at the upper pole of the left kidney, and a cystic lesion at the median region in the lower abdomen. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a cystic lesion with a slightly irregular and partially calcined wall in the lower abdomen. Cystoscopy showed a nonpapillary tumor involving the dome of the urinary bladder. Diagnosis was combined carcinomas containing a left renal cell carcinoma and an urachal tumor. The patient underwent left nephrectomy and partial cystectomy with block excision of the entire urachus and umbilicus. Pathologic examination showed a double-cancer combination of renal cell carcinoma and mucinous urachal adenocarcinoma. Urachal carcinoma is an uncommon neoplasm, although it is being reported with steadily increasing frequency. The present case is only the fourth case of double cancer with urachal adenocarcinoma to be reported in Japan, and the first reported combination with renal cell carcinoma. Our statistical study of about 116 reported cases in which diagnostic imaging of urachal carcinomas had been performed in Japan is discussed here.