1例后肾腺瘤的临床诊治并文献复习  

Clinical Diagnosis and Treatment of Metanephric Adenoma: A Case Report and Literature Review

作　　者：彭光华[1] 宋乐明[1] 刘泰荣[1] 钟久庆[1] 秦文[1] 郭树林[1] 杜传策[1] 胡敏[1] 

机构地区：[1]赣州市人民医院泌尿外科,江西赣州341000

出　　处：《实用临床医学（江西）》2014年第1期49-51,F0004,共4页Practical Clinical Medicine

摘　　要：目的探讨后肾腺瘤的临床及病理特点,以提高对后肾腺瘤的诊疗水平。方法回顾性分析1例后肾腺瘤患者的临床资料,并复习相关文献。结果顺利完成左输尿管镜碎石后2周对该患者行右肾肿瘤手术,术中行冰冻活检提示肾错构瘤,行保留肾单位的右肾部分切除手术。术后病理镜下所见:瘤细胞立方形或类圆形,核类圆形,胞浆较少,嗜碱性染色;行免疫组织化学后病理诊断考虑为后肾腺瘤。患者术后8 d痊愈出院,术后严密随访,17个月,未出现复发和转移,无瘤生存。结论后肾腺瘤极易误诊为肾癌,了解该肿瘤的临床及病理特点有助于临床诊断及鉴别诊断。后肾腺瘤的治疗多采取保留肾单位的手术,但由于其生物学行为及细胞起源的不确定性,应注意术后密切随访。Objective To investigate the clinical and pathological characteristics of metanephric adenoma, and to improve the diagnosis and treatment of metanephric adenoma. Methods Clinical data of one patient with renal adenoma who was admitted to our hospital in the last year were retrospectively analyzed and the literature was reviewed. Results Surgical procedure was performed for right renal tumor in the patient 2 weeks after successful completion of the left ureteroscopic lithotripsy. Intraoperative frozen-section biopsy indicated the features of renal hamartomas and nephron sparing surgery was performed. Postoperative pathological findings indicated that tumor cells were characterized by cubic and quasi-circular shape, quasi-circular nuclei, less cytoplasm, and acidophilic staining properties. Metanephric adenoma was considered through immunohistochemical staining： The patient was discharged from the hospital 8 days after operation. After the 17 months of follow-up, the patients had disease-free survival without recurrence and metastasis. Conclusion Metanephric adenoma is easily misdiagnosed as renal cell carcinoma. The clinical and pathological findings contribute to the clinical and differential diagnosis of metanephric adenoma. Nephron sparingsurgery is often performed for the treatment of metanephric adenoma. But due to its biological behavior and the uncertainty of cell origin, careful follow-up should be carried out in patients with metanephric adenoma.

关 键 词：后肾腺瘤 病理学 手术治疗 

分 类 号：R737.11[医药卫生—肿瘤]