肾梭形细胞癌1例报道并文献复习

摘要

目的:探讨肾恶性肿瘤罕见类型肾梭形细胞癌的临床特点、治疗及预后.方法:报告1例肾梭形细胞癌患者的临床资料,并结合文献进行讨论.结果:术前根据相关检查、结合病史及入院查体诊断左肾盂肿瘤、左肾无功能,行左肾盂癌根治术,术后病理诊断为肾梭形细胞癌.免疫组化结果示VIM(+)、CD10(+)、EMA(小灶+)、SMA(局灶+)、CD34(血管+)、CK(-)、RCC(-)、PAX-2(-)、ALK(-)、S-100(-)、Ki67(30%+).患者术后4个月死于多发性转移.结论:肾梭形细胞癌是一种高度恶性且临床上罕见的肾细胞癌,确诊有赖于典型病理表现及免疫组化,治疗以根治性肾切除术为主,放化疗等效果不佳,预后差.%Objective:To investigate the clinical characteristics,treatment and prognosis of renal spindle cell tumors (RSCTs).Methods:We reported the clinical data of one case of RSCTs,and reviewed related literature.Results:The patient was diagnosed as having left renal pelvic tumor and renal failure according to the preoperative related check,physical examination and medical history.Radical operation of renal pelvic carcinoma was performed in this case,and postoperative pathological findings confirmed the diagnosis of RSCTs.There were positive markers such as VIM(+),CD10(+),EMA (spcial mess +),SMA (partial +),CD34 (vessel +) and Ki67 (30%+),and negative markers such as CK (-),RCC (-),PAX-2 (-),ALK (-) and S-100 (-).The patient died of multiple systemic metastases after 4 months.Conclusions:RSCTs are rare and highly aggressive disease.Their diagnosis relys on pathologic and immunohistochemical examinations.Radical nephrectomy is the primary means in RSCTs,chemotherapy and radiotherapy obtain poor efficacy and the prognosis is poor.