肾嗜酸细胞腺瘤的诊疗分析（附47 例报告）

目的:分析肾嗜酸细胞腺瘤的临床特征,指导并提升诊疗水平。方法:回顾性分析47例肾嗜酸细胞腺瘤的临床资料,包括临床特点、影像表现、病理特征、治疗方法及预后等方面。结果:47例患者中43例因查体偶然发现,仅4例表现为患侧腰痛症状。术前影像诊断中1例考虑嗜酸细胞腺瘤,1例考虑腺瘤,2例CT与MRI报告不一致(CT与MRI各有1例诊断良性,具体类型不确定),其余43例均诊断为肾细胞癌(1例囊性肾癌)。27例行肾癌根治性切除术,16例行肾部分切除术,4例行微波或射频消融术。所有患者术后病理均诊断为肾嗜酸细胞腺瘤,随访4～179月,均无转移或复发。结论:肾嗜酸细胞腺瘤作为一种与肾细胞癌难相鉴别的良性肿瘤,因缺乏特异性表现,极易误诊为肾细胞癌,因此对肾肿瘤患者应尽可能选择保肾治疗方案。

The Diagnosis and Treatment of Renal Oncocytoma (47 Cases Report)

Objective: Analyzed the clinical characters of renal oncocytoma(RO) cases to improve the diagnosis and treatment.Methods: The clinical data of 47 renal oncocytoma cases were analyzed retrospectively,which included clinical manifestations,radio-graphic evaluations,pathological results,treatment protocals and prognosis.Results: 43 cases were asymptomatics and only 4 cases com-plainted of lambago on the affected sides.There were 2 cases diagnosed by radiographic evaluations as benign masses(1 of oncocytoma,1 of adenoma),2 cases got the conflicted results between CT and MRI scans(there was 1 case diagnosed as benign lesion in each groups respectively),43 cases as RCC(1 of cystic RCC).All patients received the active treatments and got the pathological diagnosis.The radi-cal nephrectomy was performed in 27 cases,16 underwent nephron sparing surgery,and 4 were treated with ablation of renal masses.All patients’ pathological results identified the diagnosis of oncocytoma.42 cases were followed up for 3 months to 15 years,and no recurrence or metastasis was detected.Conclusions: As its deficiency in specific clinical features,the RO is a benign renal mass which is difficult to differential diagnosed with RCC before operation.Nephron sparing treatments should be considered to renal masses patients as far as possible.