Funahashi Yasuhito, Kamihira Osamu, Hagikura Syoichi, Kasugai Shin, Kimura Kyosuke, Fukatsu Akitoshi, Matsuura Osamu
Department of Urology, Komaki City Hospital.
Nihon Hinyokika Gakkai Zasshi. 2008 Jan;99(1):39-42. doi: 10.5980/jpnjurol1989.99.39.
A 58-year old female was referred to our hospital due to left renal cyst that was pointed out at her health check-up. Abdominal CT scan showed left hydronephrosis with a 20 x 12 x 11cm tumor. The serum CA19-9 level elevated to 4,400 U/ml. Urinary cytology in the left renal pelvis was negative, therefore we could not diagnose whether the mass was renal cell carcinoma or renal pelvic tumor before surgery. She underwent left radical nephrectomy, and frozen section revealed renal cell carcinoma. Immunohistological stain clarified CA19-9 was limited to epithelium lining the renal pelvis and was not contained in carcinoma cells. After the surgery, the serum CA19-9 decreased to the normal range. Serum CA19-9 is known to be sometimes elevated in patients with urothelial carcinoma, but rarely elevated in those with renal cell carcinoma. We thought that hydronephrosis by tumor occlusion caused CA19-9 elevation in our case.
一名58岁女性因健康检查时发现左肾囊肿而转诊至我院。腹部CT扫描显示左肾积水，伴有一个20×12×11cm的肿瘤。血清CA19-9水平升高至4400 U/ml。左肾盂尿细胞学检查为阴性，因此术前我们无法诊断该肿块是肾细胞癌还是肾盂肿瘤。她接受了左肾根治性切除术，冰冻切片显示为肾细胞癌。免疫组织化学染色表明CA19-9仅限于肾盂内衬上皮，癌细胞中不含有。手术后，血清CA19-9降至正常范围。已知血清CA19-9在尿路上皮癌患者中有时会升高，但在肾细胞癌患者中很少升高。我们认为在我们的病例中，肿瘤阻塞导致的肾积水引起了CA19-9升高。
