肾嗜酸细胞腺瘤的临床诊治分析

目的提高肾嗜酸细胞腺瘤（renal oncocytoma,RO）的诊疗水平。方法回顾分析13例RO患者临床资料。13例患者中,男4例,女9例;肿瘤单发12例,单侧多发1例;肿瘤最大直径为1.0～6.9cm,平均3.3cm;肿瘤位于左肾上极2例,左肾中极2例,左肾下极3例,右肾上极4例,右肾中极1例,右肾下极1例。所有患者术前均行B超、IVU检查,12例行CT检查,3例行MRI检查。结果 12例术前诊断为肾癌,1例考虑为RO。13例中8例行根治性肾切除术,5例行肾部分切除术。术后病理均证实为RO。随访1～183个月无肿瘤复发或转移。结论 RO是一种临床少见的良性肿瘤,术前确诊较困难,与肾癌较难鉴别,诊断有赖于病理组织学和免疫组化检查,保留肾单位手术为首选治疗方法。

Diagnosis and treatment of renal oncocytoma

Objective To improve the diagnosis of constrictive renal oncocytoma（RO）.Methods The clinical data of 13 cases of renal oncocytom were retrospectively analyzed.Of these patients,4 were male,and 9 were female,12 had single tumor in one kidney and 1 had multiple lesions in one kidney,the diameter of the tumors were 1.0-6.9 cm,3.3 cm averagely,with 2 cases in upper pole,2 in middle pole,and 3 in lower pole of left kidney;Also,there were 4 cases in upper pole,1 in middle pole,and 1 in lower pole of right kidney.Before the operations,all the patients underwent B-ultrasonography and IVU,12 received CT scaning and 3 received MRI.Results However,only 1 in all of the cases was determined preoperatively.8 patients received radical nephrectomy,and 5 received partial nephrectomy.All cases were confirmed as renal oncocytoma by postoperative pathology.Conclusions Renal oncocytoma is a benign tumor and difficult to distinguish with renal cell carcinoma.The diagnosis of renal oncocytoma must depend on histopathological and immunohistochemical.Nephron-sparing surgery such as partial nephrectomy is valuable for such cases.