肾神经鞘瘤4例报告并文献复习

Renal schwannoma:a report of 4 cases and literature review

目的探讨肾神经鞘瘤的临床诊疗过程,提高对该病的认识和诊治水平。方法回顾性分析2016年3月至2019年12月上海交通大学医学院附属仁济医院诊治的4例经手术及病理确诊为肾神经鞘瘤的患者的临床资料。其中男性3例,女性1例,平均年龄55.8(34-65)岁。肿瘤最大径平均3.8(2.0-6.0)cm。1例行肾癌根治术,1例行肾盂癌根治术,2例行肾部分切除术。结果肾神经鞘瘤的典型影像表现与其他常见的肾脏肿瘤存在较大区别。在平均34.3(10-55)个月的随访中,所有患者未发生死亡或者复发(疾病相关生存率为100%)。结论影像学检查对于肾神经鞘瘤有部分提示作用,符合相关影像特征的肾门部占位需考虑该诊断,在技术允许的情况下推荐行保留肾单位手术,完整切除瘤体后预后良好。

Objective To explore the clinical diagnosis and treatment of renal schwannoma.Methods The clinical data of 4 cases of renal schwannoma treated in Renji Hospital during Mar.2016 and Dec.2019 were retrospectively analyzed.The patients included 3 male and 1 female,mean age 55.8(34-65)years,and mean tumor size 3.8(2.0-6.0)cm.Radical nephrectomy was performed in 1 case,radical nephroureterectomy in 1 case,and partial nephrectomy in 2 cases.Results The typical imaging characteristics of renal schwannoma were different from those of other common renal tumors.During the follow-up of 34.3(10-55)months,no recurrence or death occurred.Conclusion Preoperative imaging examination may be indicative of renal schwannoma.Renal schwannoma should be considered if imaging shows mass in renal hilum.Nephron-sparing surgery is recommended.The prognosis after complete resection of the tumor is good.Final diagnosis will be established on postoperative pathological and immunohistochemical results.