肾素瘤1例报告并文献分析

One case report of reninoma and literature analysis

目的:探讨肾素瘤相关临床表现、病理特征、诊断、治疗及预后情况。方法:回顾性分析2017年收治的1例肾素瘤患者的临床资料,结合相关文献,归纳总结肾素瘤相关临床表现、诊断、治疗及预后情况。结果:患者行腹腔镜下右肾部分切除术,术后未予以降压药,血压维持在110/70mmHg,术后病检示:肾球旁细胞瘤,免疫组化:CD34(+),SMA(-),NSE(-),CD10(-),PAX-8(-),3个月后返院检查血压、血浆肾素水平正常,行CT检查未见肿物复发。结论:肾素瘤是一种以分泌大量肾素而引起继发性高血压为特点的罕见的肾皮质良性肿瘤。但由于该疾病发病率低,临床上罕见,容易造成误诊及漏诊,确诊需结合临床表现、影像学资料和病理特征,腹腔镜肾部分切除术是治疗肾素瘤的有效方法。

Objective:To investigate the clinical manifestations,pathological features,diagnosis,treatment and prognosis of reninoma.Methods:A retrospective analysis of the clinical data of 1 case of reninoma treated in our department in 2017 was made,and the clinical manifestations,diagnosis,treatment and prognosis of reninoma in combination were summarized with related literature.Results:The patient underwent laparoscopic partial right nephrectomy without antihypertensive drugs.The blood pressure was maintained at 110/70 mm Hg.Postoperative pathological examination showed paraglomerular cell tumors,immunohistochemistry revealed CD34(+),SMA(-),NSE(-),CD10(-),PAX-8(-),the blood pressure and the plasma renin levels were normal after 3 months.No recurrence of the tumors was observed on CT.Conclusions:Reninoma is a rare renal cortical benign tumor characterized by the secretion of large amounts of renin and secondary hypertension.However,because of the low incidence of the disease,it is easily misdiagnosed.Confirmation of the diagnosis should be based on clinical manifestations,imaging data and pathological features,and laparoscopic partial nephrectomy is an effective method for the treatment of renin tumors.