摘要
肾部分切除术(PN)主要适用于局限性肾癌的治疗,可最大限度保留患肾功能。PN术后复发率较低,但复发时要注意排除炎性假瘤(IPT)的可能,避免不必要的再次手术或药物治疗。本文报道1例56岁女性患者,因右肾癌行PN,术后1年余原术区发现肿物,影像学检查提示局部复发,患者拒绝穿刺活检,遂行根治性肾切除术。术后病理证实为IPT,非肿瘤复发。在PN术后复发的诊断中,应综合分析影像学特征,如有必要应行穿刺活检以明确诊断。此外,在PN术式规范方面需加强培训,尽量减少创伤和感染的风险,以降低PN术后复发和IPT的发生率。
Partial nephrectomy(PN)is primarily used to treat small size renal cell carcinoma(RCC),aiming to minimize the impact on kidney function.Although the recurrence rate post-PN is low,vigilance in diagnosing recurrence is crucial to differentiate it from inflammatory pseudotumor(IPT)and therefore prevent unnecessary interventions.In the case of a 56-year-old female patient who underwent PN for RCC of the right kidney,a mass was identified in the original surgical site over a year later,raising concerns of local recurrence based on imaging findings.However,when the patient declined puncture biopsy,a Radical Nephrectomy(RN)was performed instead.Subsequent pathology results revealed the presence of IPT,not tumor recurrence.This case underscores the importance of a comprehensive analysis of imaging features to accurately diagnose postoperative recurrence following PN.Where uncertainty persists,puncture biopsy should be considered to provide a definitive diagnosis.Moreover,emphasizing ongoing training in PN techniques and adherence to established protocols is essential to minimize the likelihood of complications such as trauma and infection,thereby reducing the occurrence of both postoperative PN recurrence and IPT.
作者
杨春森
廖文峰
刁磊
陈斐然
杨庆
姚欣
Yang Chunsen;Liao Wenfeng;Diao Lei;Chen Feiran;Yang Qing;Yao Xin(Department of Urologic Oncology,Tianjin Medical University Cancer Institute&Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin's Clinical Research Center for Cancer,Tianjin 300060,China)
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2024年第8期629-630,共2页
Chinese Journal of Urology
基金
天津市医学重点学科(专科)建设项目(TJYXZDXK-009A)。
关键词
癌
肾细胞
肾部分切除术
炎性假瘤
复发
Carcinoma,Renal cell
Partial nephrectomy
Inflammatory pseudotumor
Recurrence
