临床极罕见的马蹄肾并肾母细胞瘤一例报告  

Rare Horseshoe Kidneys Combined with Nephroblastoma: A Case Report

作　　者：王少文[1] 侯会池[1] 李伟[1] 智亮辉[1] 刘芳[2] 王淑玉[2] 张世睿[3] 赵亮[4] 李晓辉[4] 

机构地区：[1]白求恩国际和平医院普外一科,石家庄050082 [2]白求恩国际和平医院儿科,石家庄050082 [3]白求恩国际和平医院泌尿外科,石家庄050082 [4]白求恩国际和平医院心胸外科,石家庄050082

出　　处：《临床误诊误治》2013年第3期90-91,共2页Clinical Misdiagnosis & Mistherapy

摘　　要：目的提高对马蹄肾并肾母细胞瘤的认识,减少误诊误治。方法对我院收治经手术病理检查明确诊断的马蹄肾并肾母细胞瘤1例的临床资料进行回顾性分析。结果本例因发现腹部肿物6 d入院,无明显消化系和泌尿系症状,生命体征正常,消瘦明显,CT检查示左上腹腹膜后巨大肿物,未见左肾。按腹膜后巨大肿瘤行剖腹探查术,术中见左侧腹膜后肿物,双肾于下极融合,呈马蹄状,肿瘤未超过马蹄状肾狭部。游离并切断肿物及马蹄肾狭部,缝扎右肾切缘,切断左侧输尿管,完整切除左肾肿物。术后病理检查报告:肾母细胞瘤伴片状坏死。诊断:马蹄肾并肾母细胞瘤。予放线菌素D加长春新碱化疗,病情好转出院。结论马蹄肾并肾母细胞瘤临床罕见,临床医师应提高认识,以减少误诊误治。Objective To improve the awareness of horseshoe kidneys combined with nephroblastoma in order to reduce misdiagnosis and mistreatment rates. Methods The clinical data of a patient with rare horseshoe kidneys combined with nephro- hlastoma whose diagnosis was confirmed by surgery and pathology in our hospital was retrospectively analyzed. Results The patient was admitted for abdominal mass for 6 days with no significant digestive and urinary symptoms, normal vital signs and emaciation. CT scan showed a huge mass in left and back peritoneum without the left kidney. Laparotomy surgery for retroperitoneal tumor showed a left retroperitoneal tumor with a horseshoe shape, and both kidneys were of good fusion in the lower pole, and the left kid- ney tumor did not exceed the horseshoe-shaped kidney isthmus. The left kidney and the mass were dissociated, the tumor and horse- shoe kidney isthmus were cut off, the cutting edge of right kidney was sutured and ligated, the left ureter was cut off too, and the left kidney tumor was completely resected. Pathological result showed nephroblastoma with necrosis. The patient was diagnosed as having horseshoe kidneys combined with nephroblastoma. Actinomyein D and vincristine chemotherapy were given after surgery. The patient was discharged from hospital for improved pathogenetic condition. Conclusion Horseshoe kidneys combined with nephro- blastoma is rare to clinicians, who should strengthen awareness of the disease to reduce misdiagnosis rate.

关 键 词：泌尿生殖系统畸形 并发症 肾母细胞瘤 误诊 

分 类 号：R692.12[医药卫生—泌尿科学] R737.11[医药卫生—外科学]