Abstract
A 59-year-old man had received a right nephrectomy for renal cell carcinoma of the clear cell type in September, 1984. He developed multiple lung metastases and underwent bilateral partial lung resection at another hospital in December, 1994. He had been given Interferon α (IFN α) since then. He was referred to our department for further treatment in April, 1995 at which find a mass, consistent with the left interlobar lymph node was found on the chest CT scan. He noticed hemosputum in March, 1996 and the mass was found to have increased in size despite continued IFN α treatment for ten months. He had massive hemoptysis before scheduled bronchoscopy and emergency BAE was performed.
Three days later, the left pneumonectomy with clearance of mediastinal lymph nodes was performed. The pathological section of the tumor revealed metastasis of renal cell carcinoma. It was considered that the interlobar lymph node metastasis gradually enlarged encroaching on the bronchus resulting in massive hemoptysis in this case. Lymph node dissection is necessary in the case with lymph node metastasis, though minimal lung resection is usually indicated for pulmonary metastasis of renal cell carcinoma for preservation of pulmonary function.