CAJ | 학술논문

目的探讨肾黏液小管状和梭形细胞癌(MTSCCa)的临床特点、治疗和预后. 方法 MTSCCa患者4例.均为女性.年龄42～76岁,平均57岁.腰痛2例,其中伴肉眼血尿1例;体检发现肾肿瘤2例.肿瘤位于左肾3例,右肾1例.CT检查示肾内低密度影,增强后有轻度强化,且有延迟强化.肿瘤直径3.8～12.0 cm,平均6.8 cm.T1aN0M0 1例,T1bN0M0 2例,T2N0M0 1例.4例均行根治性肾切除术,其中1例行腹腔镜手术. 结果 4例手术顺利.肿瘤大体标本切面呈灰白色或灰褐色,周边有完整包膜.肿瘤内有出血区域:镜下表现为管状和梭形结构穿插于黏液样间质中,病理均诊断为肾MTSCCa.2例术后行干扰素及IL-2免疫治疗3个月.随访9～46个月,均未见复发或转移.结论 MTSCCa是一种罕见的低度恶性肾脏上皮肿瘤,多见于女性,早期手术切除是首选治疗方法,预后良好.
목적 탐토신점액소관상화사형세포암(MTSCCa)적림상특점、치료화예후. 방법 MTSCCa환자4례.균위녀성.년령42～76세,평균57세.요통2례,기중반육안혈뇨1례;체검발현신종류2례.종류위우좌신3례,우신1례.CT검사시신내저밀도영,증강후유경도강화,차유연지강화.종류직경3.8～12.0 cm,평균6.8 cm.T1aN0M0 1례,T1bN0M0 2례,T2N0M0 1례.4례균행근치성신절제술,기중1례행복강경수술. 결과 4례수술순리.종류대체표본절면정회백색혹회갈색,주변유완정포막.종류내유출혈구역:경하표현위관상화사형결구천삽우점액양간질중,병리균진단위신MTSCCa.2례술후행간우소급IL-2면역치료3개월.수방9～46개월,균미견복발혹전이.결론 MTSCCa시일충한견적저도악성신장상피종류,다견우녀성,조기수술절제시수선치료방법,예후량호.
Objective To explore the clinical features, treatment and prognosis of mucinous tubular and spindle cell carcinoma of the kidney. Methods Patient 1, a 42-year-old woman presented with space-occupying lesion of the lower pole of the left kidney with no symptoms in physical examination for 1 week. CT revealed a low-enhanced tumor located in the lower pole of the left kidney in cT1b N0M0. Radical left nephrectomy was performed. Patient 2, a 76-year-old woman presented with space-occupying lesion of the middle of the left kidney with no symptoms in physical examination for 10 d. CT revealed a low-enhanced tumor located in the middle of the left kidney in cT1b N0 M0. Laparoscopic radical left nephrectomy was performed. The patient received adjuvant treatment with IL-2 and interferon-α 3 months after nephrectomy. Patient 3, a 50-year-old woman presented with lumbago for 3 months. CT revealed a low-enhanced tumor located in the right kidney in cT2 N0 M0. Radical right nephrectomy was performed. The patient received adjuvant treatment with IL-2 and interferon-α 3months after nephrectomy. Patient 4, a 60-year-old woman presented with lumbago and hematuria for 15 d. CT revealed a low-enhanced tumor located in the lower pole of the left kidney in cT1a N0M0.Radical left nephrectomy was performed. Results Histological examination of the tumors showed that they consisted of spindle cells arranged in tubular and trabecular patterns embedded in a myxoid stroma. Pathologic diagnosis of all 4 patients were MTSCCa. There was no evidence of recurrence in all patients for 9- 46 months. Conclusions MTSCCa is a rare low-grade renal cell carcinoma.There is a female predominance. Early surgical excision is the best treatment and the prognosis is relatively good.