青少年肾细胞癌14例临床及病理分析

Renal Cell Carcinoma in Adolescence: A Clinicopathologic Study of 14 Cases

本文报道14例年龄小于20岁的青少年肾细胞癌，占我院30年间收治肾细胞癌的5．5％，且近10年发现的病例明显多于过丧20年．由于男性患者多，发病率低，出现血尿时，易误诊为肾炎、肾结核．若仅出现腹部肿块，往往只考虑肾母细胞瘤、神经母细胞瘤等．青少年出现腹部包块、内眼血尿应想到肾癌的可能，需及时行IVP、B超、CT检查．症状中腹部肿块较成人组发生率高，血尿较肾母细胞瘤发生率高．X线平片可出现环状钙化影．病理特点是出现乳头状结构及钙化率高．本组2年生存率65％，其预后主要与临床分期有关．治疗以根治术为主．青少年肾癌有源于集合管的倾向．

Fourteen cases of renal cell carcinoma aged under 20 years are reported. accounting for 5. 5 % in all cases of renal cell.careinare in our hospital in 30 years. Most of them were male. Diagnosis were of ten delayed, belng misdiagnosed as glumerulonephritis,renal tuberculosis, nephroblastoma and neuroblastoma. IVP, B-ultrasonography and CT scanning were usually necessary for patients complained of a mass in renal area or hematuria. An abdorminal mass was palpable in 50% of patients. Hematuria was present in 57% cases. The calcification of the renal cell carcinoma was present in one patient in our group on plain film of abdomen X- ray. The average diameer of the tumor wes 8. 1cm. The papillary pattern was the most common,one of 14 cases was interpreted as a papillary carcinoma of the Bellini's ducts. The overall two-year survival rate was 65 %. The cinical stage and pseudocapsule formation were the important factors related to the survival rate. Redical nephrectomy is still the treatment of choice.