疑似肾癌的18例肾良性肿瘤诊治分析

目的探讨疑似肾癌的肾良性肿瘤的诊断和治疗。方法回顾性分析18例疑似肾癌的肾良性肿瘤患者的临床资料,并阅读相关文献。结果 18例患者的影像学检查提示诊断为肾癌。9例行根治性肾切除术,9例行保留肾单位手术。术后病理检查证实14例为嗜酸细胞腺瘤,4例为囊性肾瘤。16例术后随访3~48个月,无复发及转移。结论肾嗜酸细胞腺瘤及囊性肾瘤与肾癌术前鉴别非常困难,诊断需依靠病理组织学和免疫组化综合判断。治疗首选保留肾单位手术,术后需密切随访。

Diagnosis and treatment of 18 patients with benign renal tumors suspected of renal cell carcinoma

Objective To investigate the diagnosis and treatment of benign renal tumors suspected of having renal cell carcinoma（RCC）.Methods The clinical data of 18 patients with benign renal tumors suspected of having RCC were retrospectively analyzed.The literature of benign renal tumors was reviewed.Results Radiological imaging examination revealed that all 18 patients had RCC.Nine patients underwent radical nephrectomy,and the other 9 underwent nephron-sparing surgery（NSS）.Postoperative pathology showed that 14 patients had renal oncocytoma and 4 had cystic nephroma.Sixteen patients showed no recurrence or metastasis in a follow-up ranging from 3 to 48 months.Conclusion It is difficult to differentiate preoperative renal oncocytoma and cystic nephroma from the other renal carcinomas by radiological imaging techniques.The diagnosis can be established on histopathologic and immunohistochemical studies.NSS should be the first choice.Follow-up is essential.