不典型肾错构瘤的诊断与治疗(附18例报告)

Diagnosis and Treatment of Atypical Renal Angiomyolipoma(Report of 18 Cases)

目的:探讨不典型肾错构瘤的误诊原因,提高其诊治水平。方法:回顾性分析18例不典型肾错构瘤的临床资料。18例均行B超检查,15例行CT扫描,8例行MRI扫描,6例行IVU检查。3例接受保守治疗;15例接受手术治疗,其中3例行肿瘤剜除术,5例行肾部分切除术,7例行肾癌根治术。结果:B超诊断肾错构瘤10例(10/18),CT诊断肾错构瘤7例(7/15)。3例保守治疗者获得随访,肿瘤大小无明显变化,无转移。15例手术治疗者术后病理检查均为肾错构瘤,随访未见肿瘤转移或复发。结论:大部分肾错构瘤可通过B超、CT等影像学检查明确诊断;对于不典型肾错构瘤,术前应仔细分析影像学检查,结合病史尽量明确诊断,减少不必要的肾切除。

Objective：To discuss the misdiagnosis cause of atypical renal angiomyolipoma, and to improve its diagnosis and treatment. Methods： We analyzed retrospectively the clinical data of 18 patients with atypical renal angiomyolipoma. 18 patients made B-ultrasonography, 15 patients made CT scan, 8 patients made MRI scan, 6 patients made IVU examination. Of the 18 patients, 3 cases were treated conservatively. 15 cases underwent oper-ations, 3 cases underwent tumor enucleation, 5 partial nephrectomy, and 7 radical nephrectomy. Results：The positive diagnosis rate of ultrasonography and CT scan was 55.6%（10/18） and 46.7%（7/15）. The 3 cases treated conservatively had no change by follow-up, no significant changes in tumor size, without metastasis. 15 cases un derwent operations were confirmed renal angiomyolipoma after postoperative pathological examination, no tumor metastasis or recurrence in follow-up. Conclusions： The majority of renal angiomyolipoma can be diagnosed definitely by ultrasonography and CT scan. Careful analysis of image information before operation can help to avoid misdiagnosis of atypical renal angiomyolipoma.