首页|具髓质表型的未分类肾细胞癌2例报告并文献复习

具髓质表型的未分类肾细胞癌2例报告并文献复习

Renal cell carcinoma unclassified with medullary phenotype:a report of 2 cases and literature review

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目的 探讨具髓质表型的未分类肾细胞癌的临床特征与诊治方案,提高临床对该类型肾癌的认识.方法 回顾性分析2019-2023年南方医科大学珠江医院收治的2例无血红蛋白病而病理诊断为肾髓质癌患者的临床资料并进行文献复习.结果 2例患者均有腰部疼痛症状,经影像学检查发现肾占位性病变.患者1经术前穿刺,患者2经术后病理诊断为肾髓质癌且均缺乏镰状细胞性状或疾病证据,最终诊断为具髓质表型的未分类肾细胞癌.患者1确诊后未行进一步治疗,于确诊后5个月死亡.患者2行腹腔镜左肾切除术,术后接受吉西他滨+紫杉醇化疗+免疫治疗,患者因并发血行感染放弃一线治疗方案后肿瘤逐渐进展,最终于术后7个月死亡.结论 具髓质表型的未分类肾细胞癌与肾髓质癌的部分临床特点相似,需在病理诊断的基础上排除镰状细胞性状或疾病,由于肿瘤侵袭性强,此类患者预后均不良.
Objective To investigate the clinical features and treatment of renal cell carcinoma unclassified with medullary phenotype(RCCU-MP),so as to improve the clinical understanding of this disease.Methods The clinical data of 2 patients with pathological diagnosis of renal medullary carcinoma(RMC)in Zhujiang Hospital during 2019 and 2023 were retrospectively analyzed,and relevant literature was reviewed.Results Both patients had symptoms of backache,and imaging examination indicated renal space-occupying lesions.Case 1 was diagnosed as RMC by renal biopsy,and case 2 was pathologically diagnosed as RMC after surgery.Both cases lacked evidence of sickle cell trait or sickle cell disease,and were finally diagnosed as RCCU-MP.Case 1 did not receive antineoplastic therapy and died 5 months after diagnosis.Case 2 underwent laparoscopic nephrectomy,and then received gemcitabine+paclitaxel chemotherapy+immunotherapy.The patient's tumor progressed gradually after first-line treatment was abandoned due to concurrent hematologic infection,and he eventually died 7 months after surgery.Conclusion The clinical features of RCCU-MP are partially similar to those of RMC.The diagnosis of RCCU-MP requires pathological examinations and should exclude sickle cell trait or sickle cell disease.Due to the aggressive nature of the tumor,the prognosis of patients is poor.

renal medullary carcinomasickle cell traitSMARCB1unclassified renal cancerchemotherapy

钱羿君、刘晓华、曹漫明、杜伟、郭凯、徐亚文

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南方医科大学珠江医院泌尿外科,广东 广州 510280

广州市海珠区沙园街社区卫生服务中心,广东 广州 510280

南方医科大学珠江医院肿瘤科,广东 广州 510280

肾髓质癌 镰状细胞性状 SMARCB1蛋白 未分类肾细胞癌 化疗

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
年,卷(期):2024.29(12)