山东医药
山東醫藥
산동의약
SHANDONG MEDICAL JOURNAL
2014年
23期
37-39
,共3页
黄鸣文%刘利维%王金铸%曹利瑞%白铁男
黃鳴文%劉利維%王金鑄%曹利瑞%白鐵男
황명문%류리유%왕금주%조리서%백철남
肾肿瘤%恶性横纹肌样瘤%根治性肾切除术
腎腫瘤%噁性橫紋肌樣瘤%根治性腎切除術
신종류%악성횡문기양류%근치성신절제술
kidney neoplasms%malignant rhab doid tumor%radical nephrectomy
目的:观察成人肾恶性横纹肌样瘤的临床表现、治疗方法及预后。方法对11例成人肾恶性横纹肌样瘤患者的临床资料作回顾性分析。结果11例成人肾恶性横纹肌样瘤患者主要临床表现为腰腹疼痛4例,肉眼血尿2例,消瘦、乏力2例。 B超检查均提示肾占位性病变;CT检查均提示肾实质不规则混杂密度肿物影,肿瘤内有坏死液化,增强扫描均有不均匀强化改变。术后病理检查结果均确诊为肾恶性横纹肌样瘤。11例均行根治性肾切除术,术后辅以生物免疫治疗。根据NWTS3分期标准:Ⅰ期4例、Ⅱ期3例、Ⅲ期4例。4例术后1 a内死于肿瘤多器官转移;3例分别死于心肌梗死、脑出血、肾功能衰竭;3例术后随访7~26个月无瘤生存。结论成人肾恶性横纹肌样瘤临床表现无特异性,确诊依赖于病理学检查,应争取早期行根治性肾切除术和腹膜后淋巴结清扫术,Ⅰ期和Ⅱ期术后及时辅以生物免疫治疗疗效良好,Ⅲ期和Ⅳ期预后差。
目的:觀察成人腎噁性橫紋肌樣瘤的臨床錶現、治療方法及預後。方法對11例成人腎噁性橫紋肌樣瘤患者的臨床資料作迴顧性分析。結果11例成人腎噁性橫紋肌樣瘤患者主要臨床錶現為腰腹疼痛4例,肉眼血尿2例,消瘦、乏力2例。 B超檢查均提示腎佔位性病變;CT檢查均提示腎實質不規則混雜密度腫物影,腫瘤內有壞死液化,增彊掃描均有不均勻彊化改變。術後病理檢查結果均確診為腎噁性橫紋肌樣瘤。11例均行根治性腎切除術,術後輔以生物免疫治療。根據NWTS3分期標準:Ⅰ期4例、Ⅱ期3例、Ⅲ期4例。4例術後1 a內死于腫瘤多器官轉移;3例分彆死于心肌梗死、腦齣血、腎功能衰竭;3例術後隨訪7~26箇月無瘤生存。結論成人腎噁性橫紋肌樣瘤臨床錶現無特異性,確診依賴于病理學檢查,應爭取早期行根治性腎切除術和腹膜後淋巴結清掃術,Ⅰ期和Ⅱ期術後及時輔以生物免疫治療療效良好,Ⅲ期和Ⅳ期預後差。
목적:관찰성인신악성횡문기양류적림상표현、치료방법급예후。방법대11례성인신악성횡문기양류환자적림상자료작회고성분석。결과11례성인신악성횡문기양류환자주요림상표현위요복동통4례,육안혈뇨2례,소수、핍력2례。 B초검사균제시신점위성병변;CT검사균제시신실질불규칙혼잡밀도종물영,종류내유배사액화,증강소묘균유불균균강화개변。술후병리검사결과균학진위신악성횡문기양류。11례균행근치성신절제술,술후보이생물면역치료。근거NWTS3분기표준:Ⅰ기4례、Ⅱ기3례、Ⅲ기4례。4례술후1 a내사우종류다기관전이;3례분별사우심기경사、뇌출혈、신공능쇠갈;3례술후수방7~26개월무류생존。결론성인신악성횡문기양류림상표현무특이성,학진의뢰우병이학검사,응쟁취조기행근치성신절제술화복막후림파결청소술,Ⅰ기화Ⅱ기술후급시보이생물면역치료료효량호,Ⅲ기화Ⅳ기예후차。
Objective To observe the diagnosis , treatment and prognosis of adult malignant rhab doid tumor of the kidney .Methods The clinical data from 11 patients with adult malignant rhabdoid tumor of the kidney were retrospective-ly analyzed.Results The main clinical manifestations of 11 patients:waist pain was found in 4 cases, gross hematuria in 2 cases, weight loss and fatigue in 2 cases.B-ultrasonic examination showed all had renal lesions , computed tomography ( CT) revealed mixed density irregularities mixed with renal tumor shadow and liquefaction necrosis within the tumor , and enhanced scan showed that all had heterogeneous enhancement changing .Eleven cases underwent radical nephrectomy com-bined with postoperative immune therapy .According to the NWTS3 staging system, 4 cases had stageⅠtumor, 5 cases had stage Ⅱtumor and 2 cases had stage Ⅲtumor.Four cases died of multiple organ metastasis within 1 year after operation, 3 cases died of myocardial infarction , cerebral hemorrhage or renal failure , and 3 cases were follwed up for 7 to 26 months with disease-free survival .Conclusions The clinical manifestations of adult malignant rhabdoid tumor of the kidney have no specificity , the final diagnosis depends on pathological examination , and radical nephrectomy and retroperitoneal lymph node dissection should be done as early as possible .Immune therapy promptly after operation for stageⅠandⅡtumors re-sponds well for the prognosis , but poor efficacy for stage Ⅲand Ⅳtumors.