寺沢 良夫¹, 福田 陽一¹, 今井 恵子²

Yoshio TERASAWA¹, Yoichi FUKUDA¹, Keiko IMAI²

¹仙台社会保険病院内科, ²宏人会中央病院

¹Department of Internal Medicine, Sendai Shakaihoken Hospital, ²Koujinkai Central Hospital

キーワード : Small renal cell carcinoma, Ultrasonic abdominal examination, Slow growth, Health check-up

An attempt was made to evaluate 9 patients, who had received follow-up by ultraasonic abdominal examinations for 1 year and 2 months to 4 years and 3 months and who ultimately proved upon operation to have renal cell carcinoma.
Special attention was paid to the reason of observations and tumor growth.
Ultrasonic abdominal examinations were given to 5 patients during health check-ups to 3 patients because routine screening for hemodialysis patients, and to one patient whose chief complaint was arthralgia.
The patients received follow-up examinations for different reasons: Two were misdiagnosed as having angiomyolipoma, 3 had excessively small tomors, one was misdiagnosed as having renal cysts and was followed up for unknown reasons at other hospital, one had an obscur tumor located on the medial side of the left kidney, and one registered a difinite negative by CT and angiography.
The size of resected tumors was as follows. 1∼2 cm in 4, 2∼3 cm in 3, 3.0×4.0 cm in 1, 4.3×4.5cm in 1. The tumors grew by 1∼18 mm, during the observation periods.
This suggests that a relatively small renal cell carcinoma grows slowly.
It was feasible retrospectively to diagnose renal cell carcinoma by the initial ultrasonic abdominal examination in 7 of 9 patients. However, it was impossible to make the diagnosis by the first examination in 2 with tumors size less than 5 mm in diameter or with renal cyst lumps.