摘要
肾脏间叶性软骨肉瘤(MC)是一种罕见的软组织肉瘤,既往中英文文献中仅有29例报道。本研究分析1例肾脏MC新病例,患者女,63岁,临床表现为腰痛、血尿。CT示左肾区可见一巨大肿块影,大小13.7 cm×10.6 cm,似由多结节及肿块融合而成,其内可见多发结节及团片状钙化影,增强扫描可见较显著持续强化;MR可见斑片状、片状各序列低信号灶,DWI呈混杂高信号,增强扫描呈持续较显著强化。患者在全麻下行“左肾根治性切除+肠粘连松解术”,术后病理示左肾及肿瘤,有钙化,结合形态及免疫组化,符合肾脏MC。术后未行其他抗肿瘤治疗。随访10.5个月,患者无复发及转移倾向。提示,肾脏MC预后差,有很强的复发及转移倾向;影像学诊断肾脏MC具有一定的困难,钙化的存在提示MC的可能,特征性的病理特点是诊断MC的金标准;手术切除是肾脏MC主要的治疗措施。
Renal mesenchymal chondrosarcoma(MC)is a rare soft tissue sarcoma.There were only 29 cases reported in the Chinese and English literatures in the past.This study reported a new case of renal MC.The patient was a 63 year old female.Her clinical manifestations were loin pain and hematuria.CT showed a huge mass in the left renal area with a size of about 13.7 cm×10.6 cm,it seemed to be formed by fusion of multiple nodules and masses.Multiple nodules and mass calcification shadow could be seen in it,and obvious continuous enhancement could be seen on enhanced scan.MR showed patchy and lamellar low signal foci of various sequences,mixed high signal on DWI,and contrast-enhanced scan showed continuous and significant enhancement.The patient underwent"radical resection of left kidney and lysis of intestinal adhesion"under general anesthesia.The postoperative pathology showed calcification in the left kidney and tumor.Combined with morphology and immunohistochemistry,it was consistent with renal MC.No other anti-tumor treatment was performed after operation.After 10.5 months follow-up,the patients had no tendency of recurrence and metastasis.It is suggested that renal MC has a poor prognosis and a strong tendency of recurrence and metastasis.It is difficult to diagnose renal MC by imaging.The existence of calcification suggests the possibility of MC.The characteristic pathological characteristics are the gold standard for diagnosing MC.Surgical resection is the main treatment for renal MC.
作者
刘浅浅
陈盈秀
姬慧君
李万湖
LIU Qian-qian;CHEN Ying-xiu;JI Hui-jun;LI Wan-hu(Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan 250117,China;Department of Radiology,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan 250117,China)
出处
《社区医学杂志》
CAS
2022年第19期1111-1116,共6页
Journal Of Community Medicine
基金
山东省肿瘤医院临床研究培育项目(2020-19)
北京康盟慈善基金会伦琴影像科研专项(SD-202008-017)
作者简介
第一作者:刘浅浅,女,山东金乡人,硕士,主要从事肿瘤影像诊断的临床研究工作。E-mail:274601767@qq.com;通信作者:李万湖,男,山东茌平人,硕士,主任医师,主要从事肿瘤影像诊断的临床研究工作。E-mail:lwhvzg@126.com
