现代泌尿外科杂志2024,Vol.29Issue(5) :445-449.DOI:10.3969/j.issn.1009-8291.2024.05.013

腹膜后和盆腔恶性血管周上皮样细胞肿瘤2例临床病理特征分析并文献复习

Clinicopathological analysis of two cases of malignant perivascular epithelioid cell tumor in the retroperitoneum and pelvic cavity and literature review

陈李豪 刘凯锋 黄高振 唐泉青 李世豪 许志坚 刘宏伟
现代泌尿外科杂志2024,Vol.29Issue(5) :445-449.DOI:10.3969/j.issn.1009-8291.2024.05.013

腹膜后和盆腔恶性血管周上皮样细胞肿瘤2例临床病理特征分析并文献复习

Clinicopathological analysis of two cases of malignant perivascular epithelioid cell tumor in the retroperitoneum and pelvic cavity and literature review

陈李豪 1刘凯锋 1黄高振 1唐泉青 1李世豪 1许志坚 1刘宏伟1
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作者信息

  • 1. 广东医科大学附属医院泌尿外科研究室,泌尿外科,广东湛江 524001
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摘要

目的 探讨恶性血管周上皮样细胞肿瘤(PEComa)的临床病理特点及诊治要点以增加对该疾病的认识.方法 回顾性分析广东医科大学附属医院泌尿外科收治的2例恶性PEComa患者的临床病理资料并复习相关文献.结果 2例恶性PEComa患者均为男性,年龄分别为53、16岁,发生部位分别位于腹膜后、盆腔,均行手术切除肿瘤,经术后病理检查明确诊断.患者1肿瘤组织主要由平滑肌样细胞构成,患者2肿瘤组织主要由上皮样细胞构成,2例患者的肿瘤细胞均可见病理性核分裂象,HMB45、Melan-A、SMA、CD34均表达阳性,随访未见肿瘤复发或转移.分析文献报道的15例腹膜后或盆腔PEComa患者的资料,男性3例、女性12例,其中9例为恶性肿瘤,主要表现为腹痛、腹胀或腰痛,部分患者为体检时发现.结论 恶性PEComa术前诊断较困难,易误诊,最终确诊需要依靠术后病理结果.目前治疗以手术完整切除肿瘤为主,长期随访是关键.

Abstract

Objective To investigate the clinicopathological features and key points of diagnosis and treatment of malignant perivascular epithelioid cell tumor(PEComa)to increase awareness of the disease.Methods The clinicopathological data of 2 patients with malignant PEComa treated in our hospital were retrospectively analyzed,and relevant literatures were reviewed.Results Both patients were male,aged 53 and 16 years,respectively.The sites of occurrence were in the retroperitoneum and pelvis,respectively.Both tumors were resected surgically,and the diagnosis was confirmed with postoperative pathology.Under the microscope,the tumor tissue of one patient was mainly composed of smooth muscle-like cells,and that of the other patient was composed of epithelioid cells,both showing pathological mitotic images and expressing HMB45,Melan-A,SMA and CD34,no tumor recurrence or metastasis was observed during the follow-up.The literatures collected involved 15 patients with retroperitoneal or pelvic PEComa,including 3 males and 12 females,of which 9 were malignant.The clinical manifestations were abdominal pain,bloating,or lower back pain.Some cases were detected during physical examinations.Conclusion Malignant PEComa is difficult to be diagnosed before surgery and easy to be misdiagnosed.The confirmed diagnosis depends on the postoperative pathological results.The preferred treatment is complete resection of tumor.Long-term follow-up is needed.

关键词

盆腔肿瘤/腹膜后肿瘤/血管周上皮样细胞肿瘤/恶性肿瘤/临床病理特征

Key words

pelvic tumor/retroperitoneal tumor/perivascular epithelioid cell tumor/malignancy/clinicopathological characteristics

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基金项目

广东省基础与应用基础研究基金(2022A1515012195)

出版年

2024
现代泌尿外科杂志
西安交通大学

现代泌尿外科杂志

CSTPCD
影响因子:1.106
ISSN:1009-8291
参考文献量23
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