肾黏液性小管状和梭形细胞癌临床病理特点分析

目的:分析肾脏黏液性小管状和梭形细胞癌的临床病理特点,提高对肾黏液性小管状和梭形细胞癌的认识。方法:回顾性分析8例肾黏液性小管状和梭形细胞癌患者的临床资料。女5例,男3例,平均年龄48.4(25～80)岁。肿瘤最大直径平均4.2(2.5～10.0)cm。3例行开放性肾癌根治术,3例行腹腔镜肾癌根治术,2例行腹腔镜肾脏部分切除术。结果:手术顺利,术中术后未出现明显并发症,术后病理检查均诊断为肾黏液性小管状和梭形细胞癌。平均住院7(5～10)天,术后平均随访30(7～45)个月,均未见肿瘤复发及转移。结论:肾黏液性小管状和梭形细胞癌是一种极为罕见的低度恶性的肾脏肿瘤,临床症状、影像学表现与肾癌类似,需依靠病理组织学确诊。早期手术治疗是首选治疗方法,预后良好,需长期密切随访,对最大直径<4.0cm患者,推荐行腹腔镜下保留肾单位手术。

Clinical and pathological analysis of renal mucinous tubular and spindle cell carcinoma

Objective:To analysis the clinical pathological characteristics of renal municous tubular and spindle cell carcinoma(MTSCC).Method:We retrospectively analyzed eight renal MTSCC patients’ clinical characteristics of the Urology Department of Renji Hospital.Five patients were female,the other three were male,with a mean age of 48.4 years(range,25 to 80 years).Mean tumor size was 4.2 cm(range,2.5 to 10.0 cm).Three were treated with open radical nephrectomy,Three with laparoscopic radical nephrectomy,and the other two with laparoscopic partial nephrectomy.Result:All surgeries were performed successfully.No significant intra-operative or post-operative complications occurred.All patients were diagnosed as renal MTSCC by pathological examination after surgery.Average hospital stay was 7 days(range,5 to 10 days).There was no recurrence or metastasis in eight patients who were followed-up for a mean duration of 30 months(range,7 to 45 months).Conclusion:MTSCC is rare and a low-grade malignant renal epithelial neoplasm with good prognosis.However,accurate diagnosis can only be based on histopathologic studies.Surgery is the preferred method and the prognosis is relatively good,laparoscopic nephron sparing surgery is the first choice for those <4.0 cm neoplasms.