乏脂肪肾错构瘤的诊治体会

目的探讨乏脂肪肾错构瘤（renal hamartoma，RH）的诊断和治疗。方法回顾性分析18例乏脂肪RH的临床、影像学资料和治疗方法。结果6例CT误诊为肾癌，其中4例行肾癌根治术；14例行手术探查，5例行肾切除术，3例行肾部分切除术，6例行肿瘤剜除术。术后病理均为RH，所有患者随访3～60个月，均未见肿瘤复发。结论对乏脂肪的RH，术前需仔细分析病史及影像学资料，尽量提高该病的诊断率。治疗上，直径〈24cm单发无症状的乏脂肪RH可密切随访观察，而〉4cm者不论有无症状均应及时手术治疗。首选保留肾单位手术。乏脂肪RH经治疗后，预后良好。

Diagnosis and treatment of renal hamartoma with minimal fat

Objective To investigate the diagnosis and treatment of renal hamartoma（RH） with minimal fat. Methods The clinical and imaging data of 18 cases of RH with minimal fat were reviewed retrospectively. Results Of the 18 cases of minimal fat RH,6 cases were misdiagnosed as renal carcinoma,and 4 of them were treated with radical nephrectomy in 4 cases; 14 cases were per- formed operations research, and treated with nephrectomy（5 cases）,nephron-sparing operation （3 cases） and enucleation of tumor（6 cases）. All cases were confirmed as RH by postoperative pathology. No local relapse occurred during 3-60 months follow-up. Conclusions Careful analysis of clinical and image information can help to diagnosis of RH with minimal fat. Patients with isolated lesions less than 4 em can be followed up closely. Patients with lesions greater than 4 cm irrespective of symptoms should be performed operations research. Nephron-sparing surgery was recommended. The prognosis of RH after appropriate treatment is good.