Inoue S, Semba D, Hebisawa A, Moritsuka T, Fukatsu K, Kamiya S, Katayama T
Department of Surgery, National Tokyo Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1995 Feb;96(2):116-20.
We present a case of renal subcapsular hemorrhage caused by a small renal cell carcinoma. The patient was a 52-year-old housewife, presenting abdominal pain and vomiting, of abrupt onset. Modern imaging modalities clearly visualized a perirenal or subcapsular hematoma in her left kidney, but no underlying pathology, was found even on the arteriogram. Relying on the statistics based on more than 100 reported cases with the spontaneous renal rupture, nephrectomy was carried out. The renal carcinoma was of granular cell type (G2), and classified as pT2, pN0 and pM0. Difficulties in making a correct diagnosis as to the pathology and therefore a rational decision for nephrectomy were also stressed.
我们报告一例由小肾癌引起的肾被膜下出血病例。患者为一名52岁的家庭主妇,突发腹痛和呕吐。现代影像学检查清楚地显示其左肾有肾周或被膜下血肿,但即使在动脉造影检查中也未发现潜在病变。基于100多例自发性肾破裂的报道病例统计数据,实施了肾切除术。该肾癌为颗粒细胞型(G2),分类为pT2、pN0和pM0。文中还强调了在对病理做出正确诊断以及因此对肾切除术做出合理决策方面存在的困难。