肾脏嗜酸细胞腺瘤6例报告

Diagnosis and treatment of renal oncocytoma: Report of 6 cases

目的:探讨肾脏嗜酸细胞腺瘤的临床特征。方法:报告6例本病患者的临床资料,5例无临床表现,经B超体检偶然发现“肾脏占位”;1例腰痛、腰部不适、触及腹部包块。CT、IVU等影像学检查均有阳性发现。行肾脏部分切除术2例,根治性肾脏切除术4例。术中快速冷冻病理检查确诊。结果:6例术后均痊愈。随访13～96个月,平均78.6个月,2例随访时间未满5年,4例已超过5年(60个月),均未见肿瘤复发和转移。结论:肾脏嗜酸细胞腺瘤是一种少见的良性肿瘤,多无临床表现;影像学检查均有阳性发现;确诊有赖于病理检查,术中快速冷冻病理检查对确定术式有帮助。

Objective：To present experience on the diagnosis and treatment of renal oncocytoma with review of the literature. Methods：Data of 6 cases of renal oncocytoma diagnosed and treated from October 1995 to September 2003 were reviewed retrospectively. Four cases were male, 2 female, aging from 27 to 70 years with a mean of 58. 7 years. Four tumors were on the left, 2 on the right. Five were asymptomatic while 1 （16.7%） complained of lumbago and abdominal mass. Of the 6 cases, radical nephrectomy was performed in 4 cases because of misdiagnosis, partial nephrectomy in 2 cases. Results, All the patients recovered safely without any complications, being followed up from 13 to 96 months with a mean of 78.6 months, no relapse and metastasis occurring. Of the 6 cases, final diagnosis was made by pathological studies in 4, by immunohistochemical studies of cytokeratin 8 and vimentin in 2. Conclusions：Renal oncocytoma is an uncommon benign tumour. There is some difficulty in the diagnosis and differential diagnosis between renal oncocytoma and renal cell carcinoma by ultrasound and CT scan. Intraoperative biopsies for frozen section are emphasized to guide operation. Nephron-sparing surgery is the treatment of choice.