藏族男性原发性小细胞肾癌一例并文献复习

目的 总结原发性小细胞肾癌（RSCC）的临床特点和诊治方法.方法 报道1例69岁藏族男性RSCC的临床、影像学及病理资料,结合文献复习对该病的临床特征和诊断治疗方法进行分析.结果 患者因左侧腰痛2个月及间歇性无痛性肉眼血尿1周就诊;CT扫描发现肿瘤位于左肾上极背侧,最大径7.5 cm,术前临床分期T2aN0M0.行经腹根治性肾切除术,术后恢复良好,未接受化疗.随访6个月无复发生存.收集到文献报道的RSCC患者56例.RSCC 55例患者平均发病年龄（55.5±1.2）岁,发病高峰年龄在50～ 70岁.男女比为1.15∶1.肿瘤中位直径10.0 cm.无转移者中位生存期17.0个月;转移者中位生存期8.0个月.结论 RSCC罕见,恶性程度高,预后差;术前诊断闲难,依靠切除或者穿刺组织病理学诊断.诊断时无转移者生存期优于有转移者.

Report of renal small cell carcinoma in a Tibetan male patient and literature review

Objective To observe the diagnosis and treatment of primary small cell carcinoma of kidney.Methods The clinical characteristics,radiological and pathological findings,diagnosis and treatment were analyzed with a report of a 69-yearold Tibetan man suffering from primary small cellkidney cancer.Results The patient suffered from left flank pain for 2 months and gross intermittent painless hematuria for 1 week.CT scan revealed that the tumor located at the dorsal part of the upper pole of the left kidney with a mnaximum diameter of 7.5 cm.The clinical stage of the tumor was T2a N0 M0.A left radical nephrectomy was performed and the patient recovered and had platinum-based chemotherapy.The patient has survived for 6 months without disease recurrence.The mean age of 55 cases of primary small cell carcinoma of kidney was 55.5 years; the ratio of male to female was 1.15 to 1.0; the peak prevalence age was 5 to70 years; the median diameter was 10.0 cm; the median survival time of patients without metastasis at diagnosis was 17.0 months and the median survival time of those with metastasis was 8.0 months.Conclusion Primary small cell carcinoma of the kidney is an extremely rare neoplasm with a high degree of malignancy and poor prognosis.Preoperative diagnosis is difficult and mainly dependent on pathological diagnosis postoperatively or by needle biopsy.The comprehensive therapy includes the mainstay of platinum-based chemotherapy and nephrectomy.The median survival time of patients without metastasis is longer than that of patients with metastasis at diagnosis.