肾脏良性病变误诊为肾癌的诊治分析

目的:探讨提高肾脏良恶性肿瘤的诊断水平,降低误诊率.方法:回顾性分析我院自1995年～2005年间被误诊的肾脏良性肿瘤患者21例,年龄33～63岁,平均51岁.术前均行超声、CT等影像学检查诊断为肾癌.结果:21例患者均手术治疗.术中行冰冻病理检查3例,提示为肾脏良性占位,行肿块剜除或单纯肾切除;8例行肾癌行根治术,另外10例行单纯性肾切除术,术后病理均为肾脏良性病变.随访1～5年,无复发.结论:少数肾脏良性占位性病变仅通过影像检查很易误诊为肾癌,手术探查及术中冰冻病理检查是降低误诊率的关键.

Clinical analysis of differential diagnosis between renal cell carcinoma and renal benign space occupying mass

Objective:To improve the differential diagnosis between benign renal mass and renal cell carcinoma(RCC) so as to lower the misdiagnosis rate.Methods:A retrospective analysis was done on 21 cases of renal mass,aged ranged from 33 to 63 with a mean of 51.Among the 21 years,All of them were preoperatively diagnosed as RCC by imaging.Results:All the cases were surgically treated.Three cases underwent enucleation or simple nephrectomy because of the diagnosis as benign renal mass by intraoperative frozen section.Eight underwent radical nephrectomy.And the other 10 underwent simple nephrectomy.The pathological analysis after operation found all were renal benign changes.None developed recurrence during the follow-up of 1 to 5 years.Conclusions:Some renal benign space occupying masses could be misdiagnosed as renal cell carcinoma only by imaging examinations and surgical exploration and intraoperative frozen section by pathologic study were the keys to lower the misdiagnosis rate.