肾移植术后移植肾癌肉瘤1例报告并文献复习

目的：提高对肾移植术后移植肾癌肉瘤的认识及诊疗水平。方法：回顾性分析1例肾移植术后移植肾癌肉瘤患者的临床资料：患者女，73岁，因尿毒症于1996年10月在外院行肾移植术，移植肾置入右髂窝；因移植肾失功能于2001年3月行第二次肾移植术．移植肾置于左侧髂窝。2006年11月出现右侧移植肾区疼痛，伴镜下血尿。B超、CT检查发现右侧移植肾占位性病变而入院。在全麻下行移植。肾探查术．将右侧移植肾完整切除。结果：手术顺利，手术时间3h．出血量150ml，病理检查报告为移植肾癌肉瘤。术后2个月，患者出现排斥反应与肠梗阻，病情急剧恶化，家属放弃治疗。结论：移植肾癌肉瘤恶性程度高，预后极差．早期诊断有助于提高生存率。

Report and Review of the Literature for One Case Renal Carcinosarcoma within Allograft Kidney

Objective：To improve the experience and the level of diagnosis and treatment of renal carcinosarcoma within allograft kidney. Methods：One case of renal carcinosarcoma within allograft kidney after transplantation was reviewed. A 73 years old female patient with uremia received kidney transplantation （the kidney was placed on the right iliac fossa） in Oct 1996, and she received second transplantation for graft dysfunction （the kidney on the left side） in Mar 2001. The patient felt pain of right allograft renal region and appeared glass hematuria in Nov 2006. Space-occupying lesion was identified on the right renal allograft by the ultrasound and CT scan. aallograft renal exploration was performed under general anesthesia, and the right allograft kidney was resected complete lyResults： The surgery was successful, the operative time was 180 rain and blood loss was 150 ml. Histopathologic examination demonstrated a renal carcinosarcoma. At 2 months after operation, rejection and intestinal obstruction happened and became aggravated. The treatment was given up by the family member. Conclusions： The renal carci nosarcoma within allograft kidney is a kind of rare tumor with severe malignancy and poor prognosis. Early diagnosis may be helpful for patient survival rate.