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目的探讨乏脂肪肾错构瘤(renal hamartoma,RH)的诊断和治疗。方法回顾性分析18例乏脂肪RH的临床、影像学资料和治疗方法。结果6例CT误诊为肾癌,其中4例行肾癌根治术;14例行手术探查,5例行肾切除术,3例行肾部分切除术,6例行肿瘤剜除术。术后病理均为RH,所有患者随访3～60个月,均未见肿瘤复发。结论对乏脂肪的RH,术前需仔细分析病史及影像学资料,尽量提高该病的诊断率。治疗上,直径<4cm单发无症状的乏脂肪RH可密切随访观察,而>4cm者不论有无症状均应及时手术治疗。首选保留肾单位手术。乏脂肪RH经治疗后,预后良好。
Objective To investigate the diagnosis and treatment of renal hamartoma (RH). Methods Retrospective analysis of 18 cases of non-fat RH clinical and radiographic data and treatment. Results 6 cases of CT misdiagnosed as renal cell carcinoma, of which 4 cases of radical nephrectomy; 14 cases of surgical exploration, 5 cases of nephrectomy, 3 cases of partial nephrectomy, 6 cases of tumor resection. Postoperative pathology was RH, all patients were followed up for 3 to 60 months, no tumor recurrence. Conclusions For the lack of fat RH, preoperative careful analysis of medical history and imaging data, as far as possible to improve the diagnosis of the disease. Treatment, diameter <4cm single asymptomatic lack of fat RH can be closely followed up, and> 4cm regardless of asymptomatic surgery should be timely. Nephropathy preferred to retain surgery. The lack of fat RH after treatment, the prognosis is good.