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囊性肾瘤和混合性上皮间质瘤13例诊治体会
其他题名Diagnosis and treatment of cystic nephroma and the mixed epithelial and stromal tumor: 13 cases report
田雨; 王国良; 马潞林; 田晓军; 卢剑; 陆敏; 郎宁; 刘剑羽
关键词混合性上皮间质瘤 囊性肾瘤 诊断 治疗 Mixed epithelial and stromal tumor of kidney Cystic nephroma Diagnosis Therapy
刊名中华泌尿外科杂志
2013
DOI10.3760/cma.j.issn.1000-6702.2013.11.004
34期:11页:814-818
收录类别中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型Journal Article
摘要目的 探讨囊性肾瘤(cystic nephroma,CN)与肾混合性上皮间质瘤(the mixed epithelial and stromal tumor of kidney,MESTK)的疾病特点和诊治方法. 方法 回顾性分析2000年1月至2012年4月7例CN和6例MESTK患者的资料.CN患者7例,男3例,女4例;年龄36~69岁,平均50岁;5例无明显临床症状,为体检时B超检查发现,2例伴腰部不适;病变位于左肾3例,右肾4例;肿瘤最大径1.0~8.5 cm;CT检查均表现为Bosniak Ⅱ型.术前4例诊断为多房性肾囊肿,2例诊断为囊性肾癌可能,良性病变不除外,1例首次术前诊断为多房性肾囊肿,复发后诊断为CN.MESTK患者6例,男1例,女5例;年龄16~50岁,平均38岁;4例无明显临床症状,为体检时B超检查发现,2例伴腰部不适;病变位于左肾2例,右肾4例;肿瘤最大径3.4~ 11.0 cm;CT检查表现为Bosniak Ⅲ型5例,Ⅳ型1例.6例术前诊断为囊性肾癌可能性大,良性病变待除外. 结果 7例CN患者中,3例行后腹腔镜下囊肿去顶术,2例行后腹腔镜下肾部分切除术,1例因术前诊断为囊性肾癌、最大径达8 cm且位于肾脏中央行后腹腔镜下根治性肾切除术,1例后腹腔镜下囊肿去顶术后7个月发现肿物复发,行开放性肾部分切除术.6例MESTK患者均行后腹腔镜下根治性肾切除术.9例获随访,随访时间15个月~9年,未见复发. 结论 CN/MESTK是少见的良性肾肿瘤,个别MESTK有恶性倾向,术前误诊率高.无壁结节的多房囊性病变均应考虑CN/MESTK诊断的可能性,特别是病变凸向肾盂者应高度怀疑CN的诊断,并评估肾部分切除术的可能性.CN行单纯囊肿去顶术有复发风险. Objective To discuss the characteristics and treatment of the cystic nephroma (CN) and the mixed epithelial and stromal tumor (MESTK).Methods A retrospective collection of the clinical data of 7 CN patients and 6 MESTK patients from Jan.2000 to Apr.2012.In CN cases,there were 3 males and 4 females.Mean age was 50 years (36 to 69 years).Five cases had no symptom and were found by ultrasonic examination.Two patients had lower back discomfort.There were 3 on left side,4 right.The maximum diameter was 1.0 to 8.5 cm.Seven cases were graded as Bosniak Ⅱ by CT scan.Preoperatively 4 were diagnosed as multilocular renal cysts,2 cystic renal cell carcinoma.One case diagnosed as muhilocular renal cyst initially was diagnosed as CN when recurrence.On 6 MESTK patients,there were 1 male and 5 females.Mean age was 38 years (16 to 50 years).Four cases had no symptom and were discovered by ultrasonic examination.Two patients had lower back discomfort.There were 2 cases on left side,4 right.The maximum diameter was 3.4 to 11.0 cm.Five cases were graded as Bosniak Ⅲ and 1 was graded as Bosniak Ⅳ by CT scan.Six patients were all diagnosed as cystic renal cell carcinoma preoperatively.Results In the 7 cases of CN patients,3 accepted retroperitoneal laparoscopic cyst unroofing,2 accepted retroperitoneal laparoscopic partial nephrectomy,1 patient with a preoperative diagnosis of cystic renal cell carcinoma got retroperitoneal laparoscopic radical nephrectomy.One patient recurred 7 years after retroperitoneal laparoscopic cyst unroofing,and underwent open partial nephrectomy.All the 6 MESTK patients underwent retroperitoneal laparoscopic radical nephrectomy.Nine cases were followed up for 15 months to 9 years without recurrence.Conclusions CN and MESTK are rare benign tumors of the kidney.Few MESTK have malignant tendency.Preoperative misdiagnosis is frequent.Multi-cystic lesions with no mural nodules should take CN/MESTK into consideration.Especially when the lesions located convex to the pelvis,it should be highly suspected of CN,and the possibility of partial nephrectomy should be assessed.Cyst unroofing for CN may have risk of recurrence.
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文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/72423
专题北京大学第三临床医学院_泌尿外科
北京大学基础医学院
作者单位1.100191,北京大学第三医院泌尿外科
2.100191,北京大学第三医院病理科
3.100191,北京大学第三医院放射科
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田雨,王国良,马潞林,等. 囊性肾瘤和混合性上皮间质瘤13例诊治体会[J]. 中华泌尿外科杂志,2013,34(11):814-818.
APA 田雨.,王国良.,马潞林.,田晓军.,卢剑.,...&刘剑羽.(2013).囊性肾瘤和混合性上皮间质瘤13例诊治体会.中华泌尿外科杂志,34(11),814-818.
MLA 田雨,et al."囊性肾瘤和混合性上皮间质瘤13例诊治体会".中华泌尿外科杂志 34.11(2013):814-818.
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