囊性肾癌14例诊治体会并文献复习  

Experiences of diagnosis and treatment of cystic renal cell carcinoma with literature review: Report of 14 cases

作　　者：许晖阳 王道虎[1] 莫承强[1] 王宗仁 朱毅[1] 丘少鹏[1] 李恒爱[2] 

机构地区：[1]中山大学附属第一医院泌尿外科,广州510080 [2]中山大学附属第一医院病案管理科,广州510080

出　　处：《中华腔镜泌尿外科杂志（电子版）》2017年第5期38-41,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨囊性肾癌的影像学特征及治疗方法,了解其治疗方式选择及预后。方法回顾性分析中山大学附属第一医院2013年5月至2016年12月诊治的14例囊性肾癌病例,结合相关文献总结讨论囊性肾癌的临床表现、影像学特征、诊治和预后。结果肿瘤最大径1.8~8.1 cm,中位最大径3.3 cm。6例行根治性肾切除术,8例行肾部分切除术。14例患者中4例行开放手术,10例行微创手术。TNM分期:T1a期9例,T1b期4例,T2a期1例。术后病理肾透明细胞癌伴囊性变5例,多房囊性肾癌9例。术后1例发生切口脂肪液化,1例发生淋巴瘘,均保守治疗后好转出院。随访1~44个月,未见局部复发、转移和死亡。结论囊性肾癌是一种比较少见的肾肿瘤类型,恶性程度一般较低,CT表现有一定特征性,手术治疗效果好,首选治疗方法为保留肾单位的肾部分切除术。Objective To investigate the imaging characteristics, diagnosis methods, treatment options and prognosis of cystic renal cell carcinoma. Methods The clinical data of 14 patients with cystic renal cell carcinoma registered at our center from May 2013 to December 2016 were collected and analyzed retrospectively. The clinical manifestation, imaging characteristics, diagnosis methods, treatment options and prognosis of cystic renal cell carcinoma combining relevant literature were discussed. Results The maximum diameter of tumor ranged from 1.8 cm to 8.1 cm, and the median maximum diameter of tumor was 3.3 cm. Radical nephrectomy was performed in 6 cases and partial nephrectomy in 8 cases. There were 4 and 10 patients underwent open nephrectomy and minimally invasive nephrectomy respectively. 9 cases were classified as T1 a, 4 cases as T1 b and 1 case as T2 a for TNM staging. Postoperative pathologic examination demonstrated 5 cases of clear renal cell carcinoma with cystic changes and 9 cases of multilocular cystic renal cell carcinoma. Postoperative complications included 1 case of incisional fat liquefaction and 1 case of lymphatic fistula and they were discharged from hospital after conservative treatment. No local recurrence, metastasis and death were found within follow-up time of 1-44 months. Conclusion Cystic renal cell carcinoma is a rare subtype of renal tumors and has low malignant potential with excellent prognosis after surgical treatment. It has specific morphologic features in CT scan. Nephron sparing surgery should be regarded as the preferred surgical technique.

关 键 词：囊性肾癌 诊断 治疗 预后 

分 类 号：R737.11[医药卫生—肿瘤]