肾球旁细胞瘤的诊治(附五例报告)

The diagnosis and treatment of juxtaglomerular cell tumors (report of 5 cases)

目的 提高肾球旁细胞瘤的诊治水平。 方法 回顾分析 5例肾球旁细胞瘤患者的临床特点、诊断、治疗方式及治疗效果等临床资料。男 2例、女 3例。平均年龄 31岁。 5例临床表现均为低血钾 ,4例行血浆肾素、醛固酮测定 ,表现为高肾素、高醛固酮血症 3例 ,血浆肾素、醛固酮正常 1例。 结果 5例患者中 1例术前怀疑右肾上腺肿瘤、右肾肿瘤 ,行手术探查 ,术中冰冻病理示肾脏良性肿瘤行肾脏肿瘤剜除 ,右肾上腺活检术 ,术后病理示 :右肾球旁细胞瘤 ,正常肾上腺组织。 4例术前明确诊断者行肿瘤剜除术治疗。 5例患者术后血钾、血浆肾素、醛固酮、血压均恢复正常 ,随访 1年3个月至 10年未见肿瘤复发及高血压再发。 结论 肾球旁细胞瘤为良性肾脏肿瘤 ,术前应与原发性醛固酮增多症、肾动脉狭窄等相鉴别 ,肿瘤根治性切除效果满意。

Objective To study the juxtaglomerular cell tumor. Methods The clinical characteristics,diagnosis,surgical teratment and the prognosis of 5 patients were retrospectively studied with review of the literature. Results All the patients had hypokalemia.Peripheral serum renin levels were recorded in 4 patients and 3 of them had high levels of peripheral serum renin activity and hyperaldosteronism while these were normal in the other 1.1 patient had been preoperatively diagnosed as a right adrenal tumor with a concurrent right kidney tumor while the post-operative histopathological studied revealed normal adrenal tissue and a juxtaglomerular cell tumor of the right kidney.All patients underwent simple tumor resection.The peripheral serum renin activity,hyperaldosteronism,hypokalemia,and hypertension became normal after the tumor resection.At a mean follow-up of 58 months (range 15 to 120 months ) no tumor recurrence and hypertension has been documented. Conclusions Juxtaglomerular cell tumor is a begin tumor of kidney,being a rare, curable cause of high levels of peripheral serum renin activity,hyperaldosteronism, hypokalemia and hypertension.Differential diagnosis includes primary hyperaldosteronism and renal artery stenosis.The prognosis is good with tumor resection.