肾脏原发性恶性纤维组织细胞瘤2例诊治报告并文献复习

Primary renal malignant fibrous histiocytoma:report of 2cases and literature review

目的探讨肾脏原发性恶性纤维组织细胞瘤(malignant fibrous histiocytoma,MFH)的临床特点及治疗方法。方法总结我院2009年至2013年收治的2例肾脏MFH患者的临床资料,并结合文献进行讨论。2例患者分别以腰痛、血尿症状就诊,影像学均发现肾脏占位性病变,但缺乏特异性,均行手术治疗,术后病检确诊为肾脏MFH,术后均予辅助化疗。结果 1例随访26个月,1例随访14个月,均无肿瘤复发。结论肾脏MFH是罕见的恶性肾原发肿瘤,术前诊断困难,确诊主要依靠病理和免疫组化检查,根治性肾切除术是首选治疗方式,辅助治疗是否能改善患者预后还值得进一步探讨。

Objective To investigate the clinical manifestation and therapy of primary renal malignant fibrous histiocytoma（MFH）. Methods 2cases of renal MFH in our hospital were analyzed and summarized.Osphyalgia and hematuria were common symptoms of renal MFH.Imaging features were not typical compared with other renal arcinomas.Immunohistochemistry was essential for the diagnosis of renal MFH.2cases underwent surgical procedure. Results One patient was followed up for 26 months,another case was followed up for 14 months,and two patients had no tumor recurrence. Conclusions MFH in the kidney is a rare primary malignant tumor,which is difficult in preoperative diagnosis.It mainly depends on the pathological diagnosis and immunohistochemistry.Radical nephrectomy is the preferred way to treat it.It is also worth further investigation that whether adjuvant therapy can improve the prognosis of patients.