本文選題：甲狀腺濾泡癌樣腎細(xì)胞癌 + 腎管狀囊性癌�。� 參考：《山東大學(xué)》2014年碩士論文

【摘要】：[目的] 通過對三種腎臟罕見腫瘤(甲狀腺濾泡癌樣腎細(xì)胞癌、腎管狀囊性癌、絨毛膜癌腎轉(zhuǎn)移)進(jìn)行臨床分析,以了解其臨床特征、影像學(xué)特征、病理特點(diǎn)、鑒別診斷、治療方法及預(yù)后。 [資料和方法] 報(bào)告我院從2011年至2013年收治的甲狀腺濾泡癌樣腎細(xì)胞癌3例、腎管狀囊性癌1例、絨毛膜癌腎轉(zhuǎn)移并破裂出血1例,同時(shí)自Pubmed、Medine及中文數(shù)據(jù)庫搜索同類患者文獻(xiàn)資料文獻(xiàn)復(fù)習(xí),然后進(jìn)行匯總分析。 [結(jié)果] 1、甲狀腺濾泡癌樣腎細(xì)胞癌目前國內(nèi)外報(bào)道一共19例,結(jié)合本院收治的3例進(jìn)行匯總分析后,結(jié)果顯示甲狀腺濾泡癌樣腎細(xì)胞癌患者的平均年齡40.5±16.19歲(22～83歲,中位年齡35歲),平均腫瘤的直徑4.87±2.70厘米(1.5-11.8cm,中位直徑4.2cm)。其中女性占大多數(shù)(15/22,68.18%),且男女兩組患者發(fā)病年齡存在統(tǒng)計(jì)學(xué)差異,女性發(fā)病年齡低于男性(34.07±8.75vs.50.67±19.65, P=0.013)。其影像學(xué)特點(diǎn)和很多腎內(nèi)、腎外的良惡性病變類似,需要仔細(xì)加以鑒別�；颊呒谞钕贆z查均未發(fā)現(xiàn)占位性病變,無功能異常。縱隔無異位甲狀腺及腫瘤。本院3例患者術(shù)后隨訪超過12個(gè)月,均無復(fù)發(fā)及轉(zhuǎn)移。 2、腎管狀囊性癌臨床罕見,匯總國內(nèi)外報(bào)道83例,篩選有效病例共51例進(jìn)行統(tǒng)計(jì)學(xué)分析,結(jié)果顯示腎管狀囊性癌平均發(fā)病年齡57.43±16.07歲(18～94歲,中位年齡61歲),男女發(fā)病率之比為8：1,腫瘤平均大小4.28±3.01cm(0.2～17.0cm,58.82%≤4cm)。以性別分組,男女發(fā)病年齡及腫瘤大小無明顯差異(P0.5)；以有無臨床癥狀分組,發(fā)現(xiàn)有臨床癥狀者發(fā)病年齡(39.40±16.24)顯著低于無臨床癥狀者(59.39±14.95),P值0.049(0.05)。本例腎管狀囊性癌患者腎切除術(shù)后隨訪13月無復(fù)發(fā)及轉(zhuǎn)移。 3、絨毛膜癌腎轉(zhuǎn)移病例目前報(bào)道較少,結(jié)合本院收治的1例患者分析后可以發(fā)現(xiàn)此病的共同特點(diǎn)為：a、好發(fā)于孕齡期婦女,多繼發(fā)于正�；虍愇蝗焉�；b、突發(fā)腰腹部疼痛,壓痛、反跳痛(+)；c、血壓急劇下降；d、血hCG陽性；e、CT示腎周血腫,常伴肺轉(zhuǎn)移。 [結(jié)論] 1、甲狀腺濾泡癌樣腎細(xì)胞癌是一種非常罕見的腎上皮腫瘤,目前尚未歸屬于任何已知的腎細(xì)胞癌亞型,好發(fā)于年輕女性,臨床表現(xiàn)和其他腎腫瘤無明顯特異性,主要依靠病理形態(tài)學(xué)及免疫組織化學(xué)檢查確診。手術(shù)切除為其主要治療方法。有限資料顯示預(yù)后良好,但仍需進(jìn)一步積累病例及長期隨訪。提高對這一腫瘤的認(rèn)識可避免誤診。 2、腎管狀囊性癌是一種罕見的腎細(xì)胞癌類型,好發(fā)于男性,臨床表現(xiàn)與其他腎腫瘤無特異性,病理形態(tài)學(xué)及免疫組織化學(xué)檢查為主要確診方法,手術(shù)切除是主要治療手段,預(yù)后良好,具有低度惡性潛能。臨床需提高對此類腫瘤的認(rèn)識。 3、絨毛膜癌腎轉(zhuǎn)移較罕見,單純性絨毛膜癌經(jīng)化療后治愈率現(xiàn)已接近100%。但由于因該腫瘤惡性程度較高,生長迅速且有出血傾向,腎轉(zhuǎn)移后可能會伴有急性和快速的出血。目前治療以有效的控制出血后盡早化療為優(yōu)。臨床需與其他腎腫瘤破裂出血仔細(xì)鑒別,避免誤診而耽誤患者治療。
[Abstract]:Purpose of the project

The clinical features , imaging features , pathological characteristics , differential diagnosis , treatment methods and prognosis of three renal rare tumors ( thyroid follicular carcinoma , renal tubular cystic carcinoma , choriocarcinoma and kidney metastasis ) were analyzed .

Data and methods

Three cases of thyroid follicular carcinoma like renal cell carcinoma , 1 case of renal tubular cystic carcinoma , 1 case of choriocarcinoma and 1 case of ruptured hemorrhage were reported from 2011 to 2013 , meanwhile , literature and literature review of similar patients were searched from Pubmed , Medine and Chinese databases , and then pooled analysis was performed .

The result is not valid .

1 . A total of 19 cases of thyroid follicular carcinoma - like renal cell carcinoma were reported at home and abroad . The results showed that the mean age of patients with thyroid follicular carcinoma was 40.5 鹵 16.19 years ( 22 - 83 years , median age 35 years ) . The mean tumor diameter was 4.87 鹵 2.70 cm ( 1.5 - 11.8 cm , median diameter 4.2 cm ) . The age of female was lower than that of male ( 34.07 鹵 8.75 vs . 50.67 鹵 19.65 , P = 0 . 013 ) . The imaging features and the benign and malignant lesions outside the kidney and kidney need to be identified carefully . None of the patients in the hospital found occupying lesions and had no abnormal function .

The results showed that the average age of renal tubular cystic carcinoma was 57.43 鹵 16.07 years ( 18 - 94 years , median age 61 years ) , the ratio of male and female was 8 : 1 , the average size of tumor was 4.28 鹵 3.01cm ( 0.2 ~ 17.0 cm , 58.82 % 鈮，

本文編號：1770027