CAJ | 학술논문

目的探讨肾癌钙化骨化的发病机理、病理特点、鉴别诊断及预后. 方法患者,男,48岁.因体检发现右肾钙化性占位2周人院.CT示右肾外形不规则,肾上极町见一类圆形占位性病变,伴明显骨化.PET-CT检查示右肾上极类圆形肿块,明显钙化,不伴有高功能性,考虑良性病变.术前拟诊断为肾癌,取右侧腹直肌旁切口行右肾探查术. 结果术中见右肾中上极7.5 cmX5.0cm肿块,质硬如石,肾门周围未见肿大淋巴结,行右肾部分切除,术中冰冻病理提示肾透明细胞癌伴明显骨化,即行根治性肾切除加肾门周围淋巴组织清扫.术后病理报告:肾透明细胞癌伴广泛骨化纤维化,输尿管残端、血管残端及肾周组织未见癌组织浸润,未见转移淋巴结.术后随访8个月未见复发转移. 结论肾癌骨化较少见,肾实质性占位伴明显钙化骨化术前应按恶性肿瘤对待,肾癌骨化预后相对较好.
목적 탐토신암개화골화적발병궤리、병리특점、감별진단급예후. 방법 환자,남,48세.인체검발현우신개화성점위2주인원.CT시우신외형불규칙,신상겁정견일류원형점위성병변,반명현골화.PET-CT검사시우신상겁류원형종괴,명현개화,불반유고공능성,고필량성병변.술전의진단위신암,취우측복직기방절구행우신탐사술. 결과 술중견우신중상겁7.5 cmX5.0cm종괴,질경여석,신문주위미견종대림파결,행우신부분절제,술중빙동병리제시신투명세포암반명현골화,즉행근치성신절제가신문주위림파조직청소.술후병리보고:신투명세포암반엄범골화섬유화,수뇨관잔단、혈관잔단급신주조직미견암조직침윤,미견전이림파결.술후수방8개월미견복발전이. 결론 신암골화교소견,신실질성점위반명현개화골화술전응안악성종류대대,신암골화예후상대교호.
Objective To review the pathogenesis, pathology, diagnosis and prognosis of calci-fication or ossification renal cell carcinoma with 1 case report. Methods A 48-year-old man was re-ferred for evaluation of an incidental mass found on the upper-middle right kidney, and computed tomography showed a 7 cm tumor with extensively calcification. PET-CT found an extensively calci-fied and ossification mass without high-function in the upper-middle right kidney. Under the diagnosis of renal cell carcinoma, a transabdominal radical right nephrectomy was performed. Results During the operation, a 7.5 crux 5.0 cm well-circumscribed, encapsulated heterogeneous mass was found on the upper-middle right kidney. The patient underwent an partial nephrectomy. Frozen section diagno-sis was renal cell carcinoma with heterotopic bone formation. Then a transabdominal radical right ne-phrectomy plus regional lymph node dissection were performed. Paraffin sections showed renal cell carcinoma with heterotopic bone formation(clear cell carcinoma, pT2b No M0 ). There was neither me-tastasis nor recurrence during the 8 months follow-up. Conclusions Renal cell carcinoma with ossifi-cation is extremely rare. Renal mass with obvious substantive calcification ossification should be trea-ted as malignant mass before operation. The prognosis of renal cell carcinoma associated with ossifica-tion is relatively good.