肾恶性间叶瘤的诊断与治疗(附3例报告并文献复习)

Diagnosis and Treatment of Kidney Malignant Mesenchymomas(Report of 3 Cases and Literature Review)

目的:探讨肾恶性间叶瘤的诊断、治疗及预后。方法:回顾性分析3例肾恶性间叶瘤患者的临床资料:男2例,女1例,年龄48～68岁,平均57岁。CT平扫均为肾脏巨大不均质肿物,其中伴有大块状钙化2例,增强扫描不均质肿物有轻至中度强化。3例患者均行根治性肾切除术,术后辅以化疗或放疗。结果:3例患者术后存活6～18个月,平均11个月。结论:肾恶性间叶瘤临床罕见,术前诊断困难,确诊需依靠病理检查。综合分析临床资料及提高对此病的临床认识是避免误诊的关键。根治性切除术是其主要治疗手段,但预后不佳。

Objective： To investigate the diagnosis and treatment, prognosis of kidney malignant mesenchymomas（KMM）. Methods：3 clinical data of KMM were retrospectively reviewed in our hospital. There were 2 men and 1 woman with a mean age of 57 years（range 48 68 years）. Computed tomography scan revealed large heteroge neous mass at the kidney,with irregular calcifications（2 cases）. Contrast-enhanced CT scan showed mild moderate enhancement in the mass. All cases received radical nephrectomy combined with chemotherapy or irradiation after operation. Results：The survival lime was 6 to 18months with an average of 11 months. Conclusions： KMM is a very rare carcinoma associated with poor prognosis. Preoperative diagnosis of KMM is difficult. KMM can be diagnosed properly based on pathological features. Combined analysis of clinical data and improvement of clinical recognition of KMM is the key to avoid misdiagnosis .