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中华腔镜泌尿外科杂志(电子版)

中华腔镜泌尿外科杂志(电子版) ›› 2017, Vol. 11 ›› Issue (05) : 330 -333. doi: 10.3877/cma.j.issn.1674-3253.2017.05.010

所属专题： 经典病例； 文献；

临床研究

囊性肾癌14例诊治体会并文献复习
许晖阳1, 王道虎1, 莫承强1, 王宗仁1, 朱毅1, 丘少鹏1, 李恒爱2,†()   
  1. 1. 510080　广州，中山大学附属第一医院泌尿外科；510080　广州，中山大学附属第一医院病案管理科
  • 收稿日期:2017-02-27 出版日期:2017-10-01
  • 通信作者: 李恒爱

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

Huiyang Xu1, Daohu Wang1, Chengqiang Mo1, Zongren Wang1, Yi Zhu1, Shaopeng Qiu1, Heng'ai Li2,†()   

  1. 1. Department of Urology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
    2. Department of Medical Record, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
  • Received:2017-02-27 Published:2017-10-01
  • Corresponding author: Heng'ai Li
  • About author:
    Corresponding author: Li Heng-ai, Email:
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引用本文：

许晖阳, 王道虎, 莫承强, 王宗仁, 朱毅, 丘少鹏, 李恒爱. 囊性肾癌14例诊治体会并文献复习[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(05): 330-333.

Huiyang Xu, Daohu Wang, Chengqiang Mo, Zongren Wang, Yi Zhu, Shaopeng Qiu, Heng'ai Li. Experiences of diagnosis and treatment of cystic renal cell carcinoma with literature review: Report of 14 cases[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2017, 11(05): 330-333.

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。

关键词: 囊性肾癌, 诊断, 治疗, 预后
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 T1a, 4 cases as T1b and 1 case as T2a 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.

Key words: Cystic renal cell carcinoma, Diagnosis, Treatment, Prognosis
图1 CT平扫示左肾囊实性肿物，密度欠均匀，呈分房改变，壁可见斑点状钙化
图2 CT增强示左肾肿物实性部分及分隔呈中度强化
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