双肾多发性肾细胞癌的手术疗效分析

目的 探讨散发性双肾多发性肾细胞癌的治疗原则,以提高治疗水平. 方法 回顾性分析2000年1月至2011年7月收治的7例散发性双肾多发性肾细胞癌患者的资料.男4例,女3例.年龄40 ～ 73岁,平均57岁.无家族病史.7例均为查体或其他疾病就诊时发现.同时发现双肾癌4例,一侧肾癌术后随访发现对侧肾癌3例,未发现其他脏器及淋巴结转移.肿瘤分布于肾中央及外周,最多者一侧16枚.肿瘤直径0.8～6.0 cm,平均4.1 cm.肿瘤临床分期T1a3例,T1b 3例.结果 1例行单侧肾动脉栓塞者7个月后失访;1例靶向治疗2个疗程后双肾分期行保留肾单位(NSS)手术;3例一侧行根治术,对侧择期行NSS手术;2例双肾择期行NSS手术.7例患者病理报告均为肾透明细胞癌.6例术后随访6 ～ 96个月,平均40个月,肿瘤无复发. 结论 双肾多发肾细胞癌患者应积极实行手术治疗,以切除肿瘤、最大限度地保留肾单位为原则.患者预后不因双肾受累及肿瘤多发而受到明显影响.     

Bilateral renal cell carcinoma and renal cell carcinoma in the solitary kidney

We report on 43 patients with renal cell carcinoma in a solitary kidney, 39 of whom underwent a potentially curative resection. Of 36 patients who had a nephron salvaging procedure only 4 required ex vivo surgical resection. The survival curves of patients with solitary or bilateral lesions are similar, and depend more on the adequacy of tumor resection and tumor stage than on the fate of the contralateral kidney. Crude survival in this series was 64 per cent for patients followed for more than 1 year.     

Renal oncocytoma with bilateral synchronous renal cell carcinoma in a patient undergoing long-term hemodialysis

Abstract:   We report a case of bilateral synchronous renal cell carcinoma and renal oncocytoma in a 56-year-old male who had been treated with hemodialysis for 32 years. Because anemia gradually worsened, computed tomography and magnetic resonance imaging were carried out and revealed bilateral renal tumors within acquired cystic disease of the kidney. Bilateral nephrectomy was carried out, and the patient was diagnosed with multiple renal cell carcinomas and a single renal oncocytoma. To our knowledge, this is the first reported case of renal oncocytoma with synchronous renal cell carcinoma in a patient undergoing long-term hemodialysis.     

Bilateral synchronous open nephrectomy for renal tumours in patients following long-term dialysis

Sir, During long-term dialysis, the kidney is at maximum risk forthe development of renal cell carcinoma (RCC), and the occurrenceof bilateral cases is not rare [1,2]. Based on previous studies,bilateral nephrectomy is no longer favoured, primarily due to     

Bilateral renal cell carcinoma diagnosed as renal abscesses

The history of a patient with bilateral renal cell carcinoma, simulating bilateral renal abscesses is reported. Since hypernephroma can present with misleading systemic effects, all diagnostic tools concerning space-occupying lesions of the kidney must be interpreted with care before treatment. Punctures for cytology can be indicated when both kidneys are affected.     

Incidence, predictors and associated outcomes of renal cell carcinoma in long-term dialysis patients

We carried out an analysis of the United States Renal Data System to determine the incidence, risk factors and prognosis of renal cell carcinoma (RCC) in a national population of patients receiving incident long-term dialysis. In Cox regression, male gender, older age, end-stage renal disease caused by obstruction, tuberous sclerosis, focal segmental glomerulosclerosis, as well as acquired renal cysts, were independently associated with RCC. Most cases of RCC in incident long-term dialysis patients occurred in patients without acquired renal cysts. A diagnosis of RCC was associated with increased risk of subsequent mortality overall and in all high-risk groups.     

Bilateral renal cell carcinoma: report of a case

A case of asynchronous bilateral renal cell carcinoma is reported. The patient was a 71-year-old man who visited our clinic with complaints of asymptomatic macrohematuria and fever on November 20, 1960. Clinical diagnosis was left renal tumor and left nephrectomy was performed on December 4, 1960. Histological diagnosis was renal cell carcinoma (common type, clear cell subtype, alveolar type and G1). The postoperative course was uneventful until complaints of diarrhea and weight loss in November, 1983. He visited our clinic again with a right abdominal mass on January, 1984. Right renal selective angiography revealed an enlargement and abnormal vascularity with tumor stain, hypervascularity and pooling in the whole kidney except for the upper pole lesion. CT scan revealed a space occupying lesion. Right radical nephrectomy was performed on March 6, 1984. Histological diagnosis was renal cell carcinoma (common type, mixed subtype, alveolar and tubular type, G2). He was treated by hemodialysis and steroid therapy after right nephrectomy but he died of massive gastro-intestinal bleeding on April 22, 1984. The paper is the 15th report of a bilateral renal cell carcinoma in Japan.     

Bilateral multilocular cystic renal cell carcinoma]

A case of bilateral renal cell carcinoma with multilocular cysts is described. A 42-year-old female was admitted to our hospital for the purpose of further examination or right renal cystic mass discovered incidentally by ultrasonography. After she was examined by CT-scan and angiography, right nephrectomy was performed under the diagnosis of right renal cancer. Histological diagnosis was multilocular cystic renal cell carcinoma. One year later a small cystic legion was found in the left kidney. Under the diagnosis of left renal cancer, left partial nephrectomy was performed. Histological diagnosis was multilocular cystic renal cell carcinoma same as the right kidney. Multilocular renal cyst is classified into several classes by its style of development. This case of bilateral renal cell carcinoma which grew to be multilocular cysts is the first case in Japan as far as we can search.     

Bilateral renal cell carcinoma in a child

Renal cell carcinoma is a rare renal tumor in the pediatric population with an incidence of 0.1-0.3%. We report on the first case of bilateral renal clear cell carcinoma that was treated by partial nephrectomies. We performed a complete genetic evaluation to exclude a family inheritance and we looked at the deletions associated with the possible histologic subtypes of renal cell carcinoma. The patient had no evidence of recurrence after 80-month follow-up and her renal function remained normal.     

Successful treatment of metastatic clear cell carcinoma with nivolumab in a patient receiving dialysis treatment

The efficacy and safety of nivolumab for patients receiving dialysis treatment has not been established yet. Herein, we describe a patient on dialysis successfully treated with nivolumab as seventh‐line therapy for metastatic renal cell carcinoma. Before initiating nivolumab, he had respiratory discomfort induced by a lesion occluding the left intermediate bronchus that originated from the metastatic lymph node behind the tracheal bifurcation. Four weeks after nivolumab was initiated, his symptom remarkably improved, and the occlusion disappeared according to the bronchoscopy examination. The effectiveness and safety of nivolumab has continued for 6 months. There are few cases in which nivolumab has been given to patients on dialysis. In the present case, nivolumab was given to a patient on dialysis, and it resulted in a remarkable improvement without any adverse events.