原发性肾类癌腹腔镜根治术1例并文献复习  

THE LAPAROSCOPIC RADICAL DISSECTION OF ONE CASE PRIMARY RENAL CARCINOID AND THE REVIEW OF LITERATURE

作　　者：纳宁[1] 刘小彭[1] 洪良庆[1] 狄金明[1] 司徒杰[1] 黄文涛[1] 

机构地区：[1]中山大学附属第三医院,广东广州510630

出　　处：《现代医院》2011年第5期8-10,共3页Modern Hospitals

摘　　要：目的报道罕见原发性肾类癌1例,并探讨其临床表现、病理特点和诊治方法。方法原发性肾类癌患者1例,男,54岁。因"肾囊肿术后发现左肾占位病变2年"入院,无腰腹疼痛、血尿等症状。术前肾脏超声造影示左肾实质占位病变,大小48 mm×35 mm,不排除肾癌可能。术前CT考虑肾癌可能,其他部位未见转移瘤。行后腹腔镜下左肾癌根治术及切除侵犯的胰尾。结果肿瘤位于左肾内上方,部分突出肾表面并与胰尾粘连。术后病理示左肾原发性类癌,免疫组化示:Syn(+++),Chro-A(+),EMA(散在+),CK(+),S100(散在+)。胰尾未见癌,术后恢复良好,随访10个月未见复发和转移。结论原发性肾类癌十分罕见,文献报道多伴发于马蹄肾、畸胎瘤、多囊肾等,确诊需要组织病理学检查,治疗以手术为主。其恶性程度较低,但也可转移肝、肺、骨骼等部位,因此术后应密切随访。Objective To report a case of rare primary renal carcinoid tumor（PRCT）,and review the literatures of the characteristics of clinical pathology,diagnosis and treatment.Methods A male patient with PRCT,54 yrs,was hospitalized because of finding mass in left kidney after surgery for 2 yrs.No lumbar tenderness and hematuria.The ultrasonic contrast of kidney showed a renal mass,size 48mm×35mm,renal carcinoma weren＇t excluded.The CT scanning also showed renal carcinoma possibly and no metastasis were detected.The laparascopic radical nephrectomy was performed and the involved caudas pancreatis was also dissected.Results The tumor localized in the superior and internal portion of the left kidney.The pathologic results indicated primary renal carcinoid with positive neuroendocrine markers included： Syn（＋＋＋）,Chro-A（＋）,EMA（＋） ect.The patient was cured and no recurrence and metastasis were observed within 10 months follow-up period.Conclusion PRCT is extremely rare,and frequently associated with horseshoe kidney,renal teratoma and polycystic kidney.The final diagnosis depends on pathologic detection of neuroendocrine markers of chromogranin（Chro）,synaptophysin（Syn）,the main treatment choice is surgery.Though the prognosis of PRCT is well,metastasis of liver,bone and lymph nodes have been observed and the follow-up is necessary.

关 键 词：肾肿瘤 类癌 神经内分泌肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]