肾脏嗜酸性细胞瘤的临床诊断与治疗(附36例报告)

Diagnosis and Treatment of Renal Oncocytoma:A Report of 36 Cases

目的探讨肾脏嗜酸性细胞瘤的诊疗特点及术后的预后情况。方法回顾性分析华中科技大学附属同济医院2010年6月～2017年8月收治的36例肾脏嗜酸性细胞瘤患者的临床资料并进行随访,对患者一般情况、影像学特征、病理资料及生存情况进行分析。结果所有患者中因体检发现肿瘤者24例,因腰腹胀痛就诊者9例,因出现肉眼血尿就诊者1例,因下尿路症状就诊者1例,因自行发现肿块就诊者1例;术前行超声、CT或MRI检查者分别有23、31及15例;所有患者均行手术治疗,其中行肾部分切除术者16例,行肾肿瘤根治性切除术者17例,行冷冻消融治疗肿瘤者2例,行微波消融者1例,所有肿瘤均经病理学检查证实为肾嗜酸性细胞瘤;获得随访者33例,截止最后随访时间,全部存活。结论术前诊断肾嗜酸性细胞瘤应联合多种影像学技术手段及穿刺活检,术前无法确定肿瘤性质时,应积极手术治疗。

Objective TO examine the diagnosis and treatment of renal oncocytoma and its prognosis after surgery.Methods Clinical data of 36 patients who were diagnosed with renal oncocytoma and treated in Tongji hospital between June 2010 and August 2017 were retrospectively analyzed,including their general conditions,imaging examination results,pathologic data and follow-up data.Results Renal oncocytoma was found in 24 patients during chcck-upin 9 who presented with frequent discomfort in the abdomen and waist,in 1 due to gross hematuria,in 1 who had lower urinary tract symptoms,and in 1 who found a mass by himscH.Preoperative ultrasound,CT and MR!were conducted in 23,31 and 15 patients,respectively.All patients re ceived the surgery.The partial nephrectomy was performed in 16 cases,the radical nephrectomy in 17,renal cryoablation in 2 and microwave ablation in 1.Thirty-three patients were followed up postoperatively and all of them were alive until the last time we gave a phone call to them at January 2018.Conclusion Combination of multiple imaging techniques and needle biopsy help usdiagnose renal oncocytoma before the operation.Surgical treatment should be performed when the nature of the tumor cannot be determined before surgery.