肾血管平滑肌脂肪瘤的诊治(附39例报告)

Diagnosis and Treatment of Renal Angiomyolipoma (Report of 39 Cases)

1983年以来我院经手术和病理确诊肾血管平滑肌脂肪瘤39例,男13例,女26例,平均年龄42岁,双肾肿瘤7例,单侧多发肿瘤8例。术前主要依靠B超和CT诊断。本文比较了各种影像学检查。讨论了肿瘤的自发性破裂和出血倾向。尽管肾血管平滑肌脂肪瘤在病理有恶性存在,罕有局部浸润,未发现转移病灶。近来从DNA水平研究显示,该肿瘤为多中心源性的原发良性肿瘤。外科手术处理应根据肿瘤的具体情况,尽可能保存更多的肾组织,避免肾切除术。

39 cases of renal angimyolipoma had been confirmed by surgery and pathologic study since 1983. 13 cases were male and 26 female, with average age 42 years. 7 patients had bilateral renal involvement and 8 had multiple lesions in one kidney. Accurate preoperative diagnosis was mainly established on the basis of B-uhrasonography and CT scan. Various urologic imaging methods are compared. Intratumorous hemorrage and spontaneous rupture of the tumor are discussed. Although malignant changes had been observed in pathologic studies of renal angiomyolipoma. local invasion was rarely found and no metastatic spread. Recent studies of DNA content revealed that angiomyolipoma is a benign multicentric tumor. It is suggested that more functional renal tissue be preserved. Nephrectomy should be avoided where possible.