摘要
目的:探讨肾脏尤文氏肉瘤的病理学特点及临床诊治。方法:对2例肾脏尤文氏肉瘤患者的临床资料进行分析并复习文献。1例为33岁男性,因"体检发现左肾肿物3d"入院,CT检查示左肾下极类圆形肿块,平扫中等密度,内见多个斑片低密度区,增强扫描明显不均匀强化,静脉期强化明显,考虑肾癌,入院后行腹腔镜下肾癌根治术;另1例为55岁男性,因"反复镜下血尿2年余"入院,CT检查示左肾中部肾盂旁圆形肿块,平扫稍高密度,与肾实质分界欠清,增强扫描均匀强化,动脉期强化明显,考虑肾癌,MRI在T1W1呈等、稍低信号,T2W1呈混杂信号,考虑肾癌,入院后行经腰部肾癌根治术。结果:术后病理诊断均为肾脏尤文氏肉瘤,前1例术后长短周期交替进行化疗(短周期为环磷酰胺+长春新碱+吡柔比星,每天一次,连续2d;长周期为异环磷酰胺+依托泊苷,每天一次,连续6d),共行6个周期,周期间隔21d。化疗过程顺利,未行放疗。随访14个月,复查B超、CT等未见复发或转移。后1例术后患者及家属拒绝放疗、化疗,也不同意靶向治疗。随访3个月无复发或转移。结论:肾脏尤文氏肉瘤是一种临床罕见、来源于神经外胚层高度恶性软组织肿瘤,影像学上无特异性表现,诊断主要依据病理形态学特征及免疫组织检查,治疗上以手术切除加化疗、放疗为主,但预后不佳,有效的治疗方法有待进一步探讨。
Objective： To investigate the pathological characteristics and clinical features of the Ewing＇s sarcoma of the kidney. Methods： The clinical data of 2 cases of Ewing＇s sarcoma of the kidney and the literature were analyzed and reviewed. A 33- year- old male were examined to find a mass in the left kidney found. The CT scan revealed a solid mass in the inferior portion of the kidney with un- even enhancement by contrast. A possible diagnosis of renal carcinoma was given prior to surgery. No metastasis was proven. Another 55- year- old male were presented with microscopic hematuria repeated more than 2 years. The CT scan revealed a solid mass in the middle portion of the kidney with even enhancement by contrast. The MRI scan showed equal or slightly low signal on T1W1,mixed signal on T2W1. Considering the renal cell carcinoma,one of the two cases underwent laparoscopic radical nephrectomy,and the other open radical nephrectomy via lumbar incision. Results： Both cases＇ pathological diagnoses were Ewing＇s sarcoma of the kidney after operations. The 33- year- old male received alternating short cycle（ CTX ＋ VCR ＋ THP） and long cycle（ IFO ＋ VP- 16） adjuvant chemotherapy for 6 cycles after the operation. There has been no evidence of recurrence at the 14- month follow up. The 55- year- old male refused radiotherapy and chemotherapy,and did not agree with the targeted therapy. There has been no evidence of recurrence at the 3- month follow up. Conclusions： Ewing＇s sarcoma of the kidney is a highly malignant tumor originated from the neuroectoderm,and is rare in clinic. The diagnosis is based on histology and immunohistochemical examination since there is no specific in imaging compared to other tumors. Resection,chemotherapy and radiotherapy are the main treatments. The prognosis is poor. The effective treatment remains to be further studied.
出处
《黑龙江医药科学》
2015年第2期146-147,共2页
Heilongjiang Medicine and Pharmacy
关键词
肾肿瘤
尤文氏肉瘤
诊断
治疗
renal tumor
Ewing＇s sarcoma
diagnosis
treatment
