Sawada Y, Yamamoto S, Ogawa T, Ohkawa T
Hinyokika Kiyo. 1986 Jun;32(6):853-64.
A 78-year-old man was admitted in June 18, 1982 with a two-year history of general fatigue and loss of appetite. Physical examination revealed a child's head sized, firm, not tender, right upper quadrant mass which had an almost smooth surface and had respiratory displacement. Preoperative diagnosis was a hypovascular renal tumor presenting at the lower part of the right kidney. Right nephrectomy was performed on July 6, which displayed a specimen 1,300 g and 17 X 12 X 10 cm. The light yellow tumor appeared between the renal parenchyma and large fatty masses. The tumor was histologically diagnosed as storiform-pleomorphic malignant fibrous histiocytoma (MFH) and disclosed infiltration of both the fibrous renal capsule and adjacent perirenal fatty tissue. There was no invasion of the tumor into the renal parenchyma and the case was considered to arise from the fibrous renal capsule or the perirenal tissue. Although he had been treated with ifosfamide and adriamycin three times after operation and with immunotherapy of 3 g of PSK per day for about five months, he died three years and one month after operation. We reviewed 58 cases of MFH arising from the retroperitoneum and genitourinary tract (urological MFH) in the Japanese literature.
一名78岁男性于1982年6月18日入院,有两年全身乏力和食欲不振病史。体格检查发现右上腹有一儿童头大小、质地硬、无压痛的肿块,表面几乎光滑,随呼吸移动。术前诊断为右肾下部的乏血管性肾肿瘤。7月6日行右肾切除术,切除标本重1300g,大小为17×12×10cm。浅黄色肿瘤位于肾实质与大的脂肪块之间。肿瘤组织学诊断为席纹状-多形性恶性纤维组织细胞瘤(MFH),可见肿瘤浸润肾纤维包膜及邻近的肾周脂肪组织。肿瘤未侵犯肾实质,考虑起源于肾纤维包膜或肾周组织。术后虽接受过3次异环磷酰胺和阿霉素治疗,并每天用3g 云芝多糖K进行约5个月的免疫治疗,但术后3年1个月死亡。我们查阅了日本文献中58例起源于腹膜后和泌尿生殖道的MFH(泌尿系统MFH)病例。