儿童肾脏囊性肿瘤的诊治经验和文献复习  

Diagnosis and treatment of cystic renal neoplasm in children and literature review

作　　者：余克驰 李宁 袁继炎[1] 周学锋[1] YU Kechi;LI Ning;YUAN Jiyan;ZHOU Xuefeng(Department of Pediatric Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,430030 Wuhan,China)

机构地区：[1]华中科技大学同济医学院附属同济医院小儿外科,武汉430030

出　　处：《现代泌尿生殖肿瘤杂志》2025年第2期83-88,共6页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的 总结儿童肾脏囊性肿瘤临床特点及诊治经验,进行相关文献复习,提高疾病认识和诊治水平,避免术前误诊带来的不必要的化疗或再次手术。方法 回顾性分析华中科技大学同济医学院附属同济医院小儿外科2010年1月至2023年12月间收治14例肾脏囊性肿瘤患儿病例资料,其中男8例,女6例,平均年龄43.2个月(0.7~156.0个月),肿瘤位于左侧肾脏9例,右侧肾脏5例。主要表现为腹部包块、腹痛、血尿、发热等。所有患儿均接受手术治疗,其中囊性肾瘤4例,成熟型畸胎瘤1例,混合型上皮及间质肿瘤1例,囊性部分分化性肾母细胞瘤5例,囊性肾母细胞瘤2例,腺泡状横纹肌肉瘤1例。文献复习儿童肾脏囊性肿瘤病例中,囊性肾瘤123例,成熟性畸胎瘤1例,后肾间质瘤2例,囊性部分分化性肾母细胞瘤60例,囊性肾母细胞瘤14例,肾间变性肉瘤1例。结果 本组1例腺泡状横纹肌肉瘤患儿术前误诊为肾囊肿,肿瘤转移,放弃治疗,余13例患儿健康生存,平均随访31.1个月。文献6例患儿术前误诊,184例无瘤生存,10例死亡,3例失访,1例复发,3例带瘤生存,平均随访27.6个月。结论 儿童肾脏囊性肿瘤少见,结合其临床表现和影像学在术前精确诊断对治疗方案选择及预后有着重要作用。Objective To summarize the diagnostic and therapeutic characteristics of cystic renal tumor in children and review the related literature.Methods The clinical data of 14 cases with cystic renal tumor who underwent operation in the Department of Pediatric Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology between January 2010 to December 2023 were retrospectively analyzed.Eight males and 6 females with an average age of 43.2 months(0.7-156.0 months)were included.Clinical symptoms included abdominal or renal mass,abdominal pain,hematuria and fever.All cases received surgical treatment.The kinds of disease included cystic nephroma(CN,n=4),mature cystic teratoma(MCT,n=1),mixed epithelial and stromal tumor of kidney(MESTK,n=1),cystic partically differentiated nephroblastoma(CPDN,n=5),cystic wilm's tumor(CWT,n=2),alveolar rhabdomyosarcoma(ARMS,n=1).Two hundred and one cases with an average age of 45.9 months(0-180 months)were included in literature including CN(n=123),MCT(n=1),metanephric stromal tumor(MST,n=2),CPDN(n=60),CWT(n=14)and anaplastic sarcoma(AS,n=1).Results Preoperative misdiagnosis rate was 7.1%(1/14).The average follow-up time was 31.1 months.Thirteen cases survived well.In literature,preoperative misdiagnosis rate was 3.0%(6/201).Ten cases died,and 3 patients were lost to follow-up.One patient relapsed.Three patients were alive with tumor,while 184 patients were alive without tumor.The average follow-up time was 27.6 months.Conclusions Cystic renal tumors in children are rare,so an accurate preoperative diagnosis combined with clinical manifestations and imaging plays an important role in the choice of treatment and prognosis.

关 键 词：囊性肿瘤 肾脏 儿童 

分 类 号：R737.11[医药卫生—肿瘤]