肾癌伴下腔静脉癌栓的诊断及治疗（附11例报告）

报告１１例肾细胞癌伴下腔静脉癌栓患者，男９例，女２例；右侧８例，左侧３例。临床症状：血尿９例，腹部肿物２例，仅１例出现下肢水肿、腹壁浅静脉扩张。全部病人均经ＣＴ扫描或ＣＴ和ＭＲＩ检查明确诊断。１０例经上腹正中或胸腹联合切口取出癌栓连同患肾一并切除。５例术前无其它部位转移者术后平均存活５年２个月，１例术后２个月死亡，２例术前肾蒂淋巴结及肾周脂肪侵犯者中１例存活２年５个月死于非肿瘤疾病，１例目前已存活３年１个月尚在，２例失访。本组腔静脉癌栓发生率占同期肾癌病人的２．７％。本组ＣＴ与ＭＲＩ相结合应用诊断符合率为９８０％。

Renal cell carcinoma with inferior vena cava tumor emboli(report of 11 cases)

cases of renal cell carcinom with inferior vena cava tumor emboli were reported,9 of the patients being male and 2 female.The primary lesion was on the right side in 8 and on the left in 3.The presenting symptom was hematuria in 9 and an abdominal mass palpated in 2.Edema of the lower extremity and dilatation of the superficial vein of the abdominal wall were noted only in 1 patient.The exact diagnosis was made on CT scanning of CT MRI in all.For 10 of the patients,nephrectomy and extraction of the emboli were carried out.The average survival of 5 patients without other distant metastasis has been 5 years and 2 months.1 of the 5 died 2 months after the operation.Of the 2 cases with tumor invasion into the perirenal fat and the hilum nodes,1 has already survived for 3 years and 1 month and the other died of disease other than the malignant tumor after 2 years and 5 months.The occurrence of inferior vena cava emboli was noted in 2.7% of our renal carcinoma patients,and the accurate diagnosis rate of CT combined with MRI has been 98%.