肾嗜酸细胞瘤术前诊断与治疗(附13例报告)

Preoperative diagnosis and therapy for renal oncocytoma(Report of 13 cases)

目的：通过对嗜酸细胞瘤的临床特点和术前影像学诊断的分析,探讨肾嗜酸细胞瘤的诊断与治疗方法。方法：回顾性分析2003-2013年我院收治的13例（男9例,女4例）肾嗜酸细胞瘤患者的临床特点、诊疗经过以及术后随访结果。结果：所有患者均接受手术治疗,其中2例行肾部分切除术,11例行肾根治性切除术,肿瘤平均直径（4.2±1.5）cm。术中均未见淋巴结转移,肿瘤位于肾实质内,呈圆形或椭圆形,与周围组织界限清晰,术前临床诊断均为肾癌,术后病理均诊断为肾嗜酸细胞瘤。患者平均随访43（7-68）个月,均无复发、进展或死亡。结论：肾嗜酸细胞瘤是一种少见的良性肿瘤,临床表现无特异性,术前容易误诊为肾癌。考虑肾嗜酸细胞瘤与肾癌相比预后良好,对于疑似病例,术前诊断应慎重,仔细分析影像学检查资料,必要时行术中冷冻病理学检查以避免不必要的肾切除。

Objective：To analyze the clinical features and preoperative imaging diagnosis of renal oncocytoma（RO）and to discuss its diagnosis and treatment.Method：The data of 13patients（nine males and four females）of RO in the department of urology of our hospital from 2003 to 2013were collected.Retrospective analyses of clinical characteristics of RO patients including pathological characteristics and long term follow-up results,treatment methods,and prognosis were taken.Result：All patients underwent surgery,including two partial nephrectomies and 11 renal radical resection surgeries.The mean diameter of resected tumor was（4.2±1.5）cm.All patients showed no lymph node metastasis.Tumors were round or oval,located in the boundaries of the renal parenchyma and the surrounding tissue is clear.All preoperative clinical diagnoses were kidney cancers,and RO was diagnosed by postoperative pathology.The average follow-up period was 43（range,7-68）months,and there was no recurrence,progression or death.Conclusion：RO is a rare benign tumor with good prognosis.However,it tends to be confused with renal cell carcinoma for it has no specific clinical features.To avoid unnecessary nephrectomy,the result of image examination should be analyzed carefully and intraoperative cytology and frozen sections should therefore be performed if necessary.