摘要
目的:探讨肾血管平滑肌脂肪瘤(RAML)的诊断和治疗方法。方法:回顾性分析102例肾血管平滑肌脂肪瘤患者的临床资料,按肿瘤直径分为3组:A组21例(<4cm),B组(≥4～≤8cm)63例,C组(>8cm)18例。结果:A组中17例(81%)患者无任何症状,其中3例行肿瘤剜除术,其余患者定期随访。B组中50例(79%)患者有临床症状,44例行肿瘤剜除术,8例行肾部分切除术,4例行肾切除术,2例行肾癌根治切除术,5例患者定期随访。C组中16例(88%)患者有临床症状,所有病例都进行了手术治疗,其中4例行肿瘤剜除术,6例行肾部分切除术,2例行肾癌根治切除术,1例行选择性肾动脉栓塞术后择期行肾切除术,在6例行肾切除术的患者中,有一例因伴发下腔静脉瘤栓而同时行了下腔静脉瘤栓取出术。所有病例术后病理检查均证实为肾血管平滑肌脂肪瘤。结论:肿瘤直径<4cm的患者多无临床症状,可临床随访;肿瘤直径≥4cm的患者应积极行手术治疗,以保留肾单位的手术为首选。
Objective： To discuss the diagnosis and treatment of renal leiomyolipoma. Methods： Clinical data of 102 cases of renal leiomyolipoma were reviewed retrospectively. The cases were divided in 3 groups based on the diameter of the tumor; Group A （〈4cm）, Group B （≥4 -≤8cm） and Group C （ 〉 8cm）. Results： In Group A, 81% （17/21） of the patients were asymtomatie, 3 patients had undergone enucleation of the lesion, the others were followed up without surgical intervention; in Groups B, 79% （50/63） had clinical complaints and of the 63 cases, tumor enucleation was clone in 44, partial nephrectomy in 8, nephrectomy in 4, radical nephrectomy in 2 and regular follow - up in 5 and in Group C, 88% （16/18） of the patients were symptomatic, acquired surgical operation including tumor enucleation was done in 4, partial nephrectomy in 6, radical nephreetomy in 2, selective emergency arterial embolization followed by nephrectomy in 1, and nephrectomy in 6 of which dislodged tumor embolus from infenor vena cavd. All cases were cold]ruled by pathology after operation. Conclusion： The patients with RAML〈 4cm could likely to be asymtomatic and could be observed from follow- up. With RAML≥4cm, surgery was ecessary. Nephron - sparing surgery （NSS） was the optimal choice.
出处
《华西医学》
CAS
2005年第3期451-452,共2页
West China Medical Journal
