Abstract
Case 1 : A 58-year-old man who had been receiving maintenance hemodialysis therapy for 28 years underwent computed tomography (CT) for elevated C-reactive protein level of unknown cause. CT showed multiple liver tumors, and a chemotherapy regime was started. Autopsy showed right spindle cell renal cell carcinoma (RCC) with multiple metastases. Case 2 : A 61-year-old man began hemodialysis therapy at the age of 47 years because of the loss of a kidney graft. At the age of 61 years, he underwent laparoscopic right radical nephrectomy. Pathological examination indicated spindle RCC. Three months after the operation, CT showed metastases to the liver and rectum. Despite administration of everolimus, the patient died of disease progression. Case 3 : A 60-year-old man who had been receiving maintenance hemodialysis therapy for 25 years presented with high fever of unknown origin and anorexia. CT showed multiple liver masses and renal cysts. Because he had right dorsal pain and continuous fever, we suspected right renal cyst infection or RCC, and laparoscopic right nephrectomy was performed. A pathological examination indicated spindle RCC. Two weeks after the operation, the patient died of a cardiogenic embolism. It is well known that regular screening by abdominal echo and CT are useful for long-term dialysis patients. However, we need to recognize that some cases of spindle RCC in hemolysis patients are difficult to diagnose with imaging tests.
