肾及肾周脂肪肉瘤9例临床分析

Clinical analysis of 9 cases of renal and perirenal liposarcoma

目的:总结肾及肾周脂肪肉瘤的临床表现、治疗及预后特点,以提高对该病的诊治水平。方法:回顾性分析2009年8月~2017年12月上海交通大学医学院附属仁济医院泌尿外科诊治的9例经手术和病理检查证实的肾及肾周脂肪肉瘤患者的临床资料及随访结果。结果:男7例,女2例;平均年龄59.4(50~74)岁,平均肿瘤直径21.6(13~33)cm,患者均行根治性切除术。其中来源于肾脏者6例,来源于肾周者3例;累及肾上腺者2例,侵犯脾脏者1例,侵犯患侧小肠者1例,侵犯肝脏者1例。结论:肾及肾周脂肪肉瘤属罕见类型,患者确诊依赖于术后病检,患者早期往往缺乏典型临床症状,发现时多属疾病中晚期,手术根治难度较大。手术治疗的关键在于肿瘤切除的完整性,而早期诊断及根治性治疗有望降低肿瘤复发率,提高患者的生存率。

Objective:To summarize the clinical manifestations,treatment and prognosis characteristics of renal and perirenal liposarcoma,so as to improve the diagnosis and treatment of this disease.Method:The clinical data and follow-up results of 9 cases of renal and perirenal liposarcoma confirmed by surgery and pathology in the department of urology,Renji Hospital Affiliated to Shanghai Jiao Tong University from August 2009 to December 2017 were retrospectively analyzed.Result:There were 7 males and 2 females,with an average age of 59.4(range,50-74)years old.The average diameter of the tumor was 21.6(range,13-33)cm,and radical resection was performed.Pathology confirmed 6 cases of renal liposarcoma and 3 cases of perirenal liposarcoma.Two cases were found adrenal invasion.One case was found invasion of the spleen.One case was found small intestine invasion,and liver invasion was found in 1 case.Conclusion:The renal and perirenal liposarcoma is a rare type without typical clinical symptoms,and difficult to be diagnosed and radically resected.The key point of surgical treatment is complete excision of lesions.So reducing recurrence rate and improving survival rate of the patients rely on early diagnosis and radical resection.