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目的:分析肾脏黏液性小管状和梭形细胞癌的临床病理特点,提高对肾黏液性小管状和梭形细胞癌的认识。方法:回顾性分析8例肾黏液性小管状和梭形细胞癌患者的临床资料。女5例,男3例,平均年龄48.4(25～80)岁。肿瘤最大直径平均4.2(2.5～10.0)cm。3例行开放性肾癌根治术,3例行腹腔镜肾癌根治术,2例行腹腔镜肾脏部分切除术。结果:手术顺利,术中术后未出现明显并发症,术后病理检查均诊断为肾黏液性小管状和梭形细胞癌。平均住院7(5～10)天,术后平均随访30(7～45)个月,均未见肿瘤复发及转移。结论:肾黏液性小管状和梭形细胞癌是一种极为罕见的低度恶性的肾脏肿瘤,临床症状、影像学表现与肾癌类似,需依靠病理组织学确诊。早期手术治疗是首选治疗方法,预后良好,需长期密切随访,对最大直径<4.0cm患者,推荐行腹腔镜下保留肾单位手术。
OBJECTIVE: To analyze the clinicopathological features of renal mucinous tubulocytic and spindle cell carcinomas and to raise awareness of renal mucinous tubule and spindle cell carcinoma. Methods: The clinical data of 8 patients with renal mucinous tubule and spindle cell carcinoma were retrospectively analyzed. 5 females, 3 males, average age 48.4 (25 ~ 80) years old. The largest diameter of tumor average 4.2 (2.5 ~ 10.0) cm. 3 cases of open radical nephrectomy, 3 cases of laparoscopic radical nephrectomy, 2 cases of laparoscopic partial nephrectomy. Results: The operation was smooth and no obvious complications occurred during and after operation. Postoperative pathological examination was diagnosed as renal mucinous tubule and spindle cell carcinoma. The average hospitalization was 7 (5 ~ 10) days, with an average follow-up of 30 (7 ~ 45) months. No tumor recurrence and metastasis were found. Conclusions: The mucinous tubular and spindle cell carcinoma of the kidney is a very rare low grade neoplastic kidney. The clinical manifestations and imaging findings are similar to those of renal cell carcinoma, and the diagnosis of renal mucosa depends on histopathology. Early surgical treatment is the preferred treatment, the prognosis is good, requiring long-term close follow-up, the maximum diameter of <4.0cm patients recommended laparoscopic nephron surgery is recommended.