XU Min,GU Song,PAN Ci,et al.The management of non-wilms renal tumors in children[J].Journal of Clinical Pediatric Surgery,2013,12(02):93-96.[doi:10.3969/j.issn.1671— 6353.2013.02.005]
儿童非肾母细胞瘤肾脏肿瘤的临床治疗探讨
- Title:
- The management of non-wilms renal tumors in children
- Keywords:
- Kidney Neoplasms/TH; Child
- 摘要:
- 目的 总结和探讨儿童非肾母细胞瘤肾脏肿瘤的治疗方法。 方法 1998年7月至2010年7月我们共收治非肾母细胞瘤肾脏肿瘤患儿18例,其中男性14例,女性4例,年龄最大9岁,最小2个月,平均年龄(40.17±34.04)个月,术后病理诊断包括肾透明细胞肉瘤9例(9/18,50%),肾横纹肌样瘤2例(2/18,11.1%),肾癌2例(2/18,10.1%),肾中胚层肾瘤1例(1/18,5.56%),后肾间质瘤1例(1/18,5.56%),后肾腺瘤1例(1/18,5.56%),肾血管平滑肌脂肪瘤1例(1/18,5.56%),肾原始神经外胚叶瘤1例(1/18,5.56%)。 结果 随访9例肾透明细胞肉瘤,8(8/9)例无瘤生存,最长随访时间5年,最短2个月,平均随访时间(24.56±17.27)个月,1例手术化疗后下腔静脉瘤栓残留水平至右心房入口,放弃治疗1.5年后死亡。2例肾横纹肌样瘤经手术、放疗及化疗,随访3年和4年均无瘤存活。2例肾癌单纯手术切除,密切随访25个月、13个月无复发及转移。1例肾原始神经外胚叶瘤经手术及化疗,随访16个月无瘤存活。1例肾中胚层肾瘤、1例后肾间质瘤、1例后肾腺瘤、1例肾血管平滑肌脂肪瘤均完整切除,现最长随访时间4年,最短1年,无一例复发。 结论 儿童非肾母细胞瘤肾脏肿瘤所占比例虽小,但临床鉴别诊断困难,病理诊断非常重要,手术、化疗及放疗综合治疗是诊治的首要选择。
- Abstract:
- Objetive To present our experience of managing non-wilms,renal tumors in children. Methods During From July 1998 to July 2010, 18 cases of non-wilms, renal tumors in children were treated.14 cases were male, 4 cases were female, age ranged from 9 years to 2 months, mean age was 40.17 ± 34.04 months.The pathological diagnosis included 9/18(50%)cases of clear cell sarcoma,2/18(11.1%)cases of rhabdoid tumor of kidney, 2/18(10.1%)cases of renal cell carcinoma,1/18(5.56%)case of mesoblastic nephroma, 1/18(5.56%)case of metanephric stromal tumor,1/18(5.56%)case of metanephric adenoma, 1/18(5.56%)cases of angiomyolipoma, 1/18(5.56%)case of primitive neuroectodermal tumor. Results 8/9cases of clear cell sarcoma cases were survival,whose average follow-up time was 24.56±17.27 months,1 case died after giving up treatment 1.5 year. 2/cases of rhabdoid tumor of kidney were survived after surgery and chemotherapy, follow-up time was 3 years and 4 years. 2 cases of renal cell carcinoma were survived after surgery, follow-up time was 13 months and 25 months. 1 case of primitive neuroectodermal tumor was survived after surgery and chemotherapy,follow-up time was 16 months. 1 case of mesoblastic nephroma、metanephric stromal tumor 、metanephric adenoma and angiomyolipoma survived without relapse. Conclusions Although non-wilms renal tumors is a small part of all kidney tumor, it is difficult to identify from other tumors. So pathological diagnosis is essential. Surgical treatment combined with radiotherapy and chemotherapy is essential.
参考文献/References:
1 Argani P, Perlman EJ, Breslow NE, et al. Clear cell sarcoma of the kidney: a review of 351 cases from the National Wilms Tumor Study Group Pathology Center[J].Am J Surg Pathol, 2000,24: 4— 18. 2汤静燕,潘慈,徐敏,等.上海儿童医学中心WT — 99方案诊治儿童肾母细胞瘤临床报告[J].中华儿科杂志2003; 41:131 — 134. 3Green DM, Breslow NK, Beckwith JB, et al. Treatment of children with clear cell sarcoma of the kidney: a report from the National Wilms Tumor Study Group[J]. J Clin Oncol, 1994,12:213 2— 2137. 4Weeks DA, Beckwith JB, Mierau GW, et al. Rhabdoid tumor of kidney: A report of 1 11cases from the National Wilms Tumor Study Pathology Center[J]. Am J Surg Pathol, 1989,13:43 9— 458. 5Cook A, Lorenzo AJ, Salle JL, et al. Pediatric renal cell carcinoma: single institution 2 5year case series initial experience with partial nephrectomy[J].J Urol, 2006,175:145 6— 1460. 6Barros LR, Glina S, Melo LF. Renal cell carcinoma in childhood[J]. Int Braz J Urol, 2004,30:22 7— 229. 7Indolfi P, Terenziani M, Casale F, et al. Renal cell carcinoma in children: a clinicopathologic study[J]. J Clin Oncol, 2003, 21:530 — 535. 8Parham DM, Roloson GJ, Feely M, et al. Primary malignant neuroepithelial tumors of the kidney: a clinicopathologic analysis of 14 6adult and pediatric cases from the National wilms Tumor Study Group Pathology Center[J]. Am J Surg Pathol, 2001,25:13 3— 146.
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