泌尿生殖系统炎性肌纤维母细胞瘤14例报告

Inflammatory myofibroblastic tumor in genito-urinary system:A report of 14 cases

目的探讨泌尿生殖系统炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor,IMT)的临床特点与诊治。方法回顾性分析我科2007年1月-2011年12月收治14例泌尿生殖系统IMT的临床资料。男6例,女8例;年龄17-57岁,平均32岁;其中膀胱IMT 8例,肿瘤直径1.5-4.5cm;经尿道膀胱肿瘤电切术7例,膀胱部分切除+输尿管膀胱再植术1例;肾脏IMT 3例,肿瘤直径2-3.5cm;肾肿瘤剜除术2例,抗炎治疗1例;前列腺、睾丸、附睾IMT各1例,前两者行抗炎治疗,后者行附睾切除术。结果随访3-50个月,平均21个月,膀胱肿瘤术后复发1例;肾肿瘤手术治疗2例均无复发,行抗炎治疗病例5个月后复发,再次行抗炎治疗后18个月无复发;前列腺肿瘤抗炎治疗后3个月复发,后行前列腺切除术,随访20个月无局部复发;睾丸及附睾肿瘤治疗后均无复发。结论泌尿生殖系统炎性肌纤维母细胞瘤临床少见,治疗以手术切除为主,少部分病例可采用抗炎治疗。

Objective To study the clinical characteristics, diagnosis and treatment of inflammatory myofibroblastic tumor（IMT） in genitor-urinary system. Methods Clinical data about 14 patients with IMT in genitor-urinary system（6 males and 8 females） at the age of 32 years（range 15-57 years） admitted to our hospital from January 2007 to December 2011 were retrospectively analyzed. Of the 14 patients, 8 were diagnosed with cystic IMT with a diameter of 1.5-4.5cm（7 underwent transurethral resection of bladder tumor and 1 underwent partial cystectomy ＋ ureterocysto-reimplantation）, 3 were diagnosed with renal IMT with a diameter of 2-3.5cm （2 underwent enucleation and 1 received anti-inflammatory therapy）, 1 was diagnosed with prostatic IMT and 1 was diagnosed with testis IMT（both received anti-inflammatory therapy）, and 1 was diagnosed with epididymis IMT（who underwent epididymectomy）. Results The patients were followed up for 3-50 months（mean 21 months）. Cystic tumor relapsed in l patient after operation. Although renal tumor did not recur in 2 patients after operation but recurred 5 months after anti-inflammatory therapy, which did not relapse after an additional 18-month anti-inflammatory therapy. Prostatic tumor relapsed 3 months after anti-inflammatory therapy and did not recur during the 20-month follow-up period. Testis and epididymis tumor did not recur after anti-inflammatory therapy. Conclusion IMT in genitor-urinary system is rare. Surgical transaction is the main choice of its treatment and a mall number of patients can be treated with anti-inflammatory therapy.