Neuzillet Yann, Lechevallier Eric, André Marc, Daniel Laurent, Nahon Olivier, Coulange Christian
Service d'Urologie, Hôpital Salvator, Marseille, France.
Prog Urol. 2006 Sep;16(4):435-8.
Renal oncocytoma is a benign tumour that is usually diagnosed postoperatively. Its natural history is poorly defined. We studied the outcome of patients with renal oncocytoma diagnosed by percutaneous biopsy and not operated.
From January 1998 to April 2004, on a series of 148 renal tumour biopsies performed in our centre, 15 showed oncocytoma. The initial treatment was non-surgical. We report the follow-up of these patients and the course of these oncocytomas. The mean follow-up was 404 +/- 20.9 months.
The mean age of these patients at diagnosis was 57.6 +/- 14.4 years and the mean tumour diameter was 3.49 +/- 2.43 cm with a mean volume of 62.3 +/- 135.4 cm3. Six of these 15 patients were operated: 4 total nephrectomies and 2 partial nephrectomies. The indications for surgery were the initial tumour volume (n = 1), tumour growth > 0.5 cm/year (n = 4) and the patient's preference (n = 1). Operated patients were younger (45.5 +/- 11.1 years vs 65.6 +/- 10.3 years) and had larger tumours at diagnosis (50 +/- 30.1 mm vs 27.3 +/- 10.5 mm). All 9 patients treated by watchful waiting were asymptomatic.
The natural history of oncocytomas appears to be a more or less rapid increase in size. Treatment can be conservative. The initial tumour volume or rapid tumour growth are indications for resection. Partial nephrectomy, when allowed by the size and site of the tumour is currently the technique of choice.
肾嗜酸细胞瘤是一种通常在术后才被诊断出的良性肿瘤。其自然病程尚不明确。我们研究了经皮活检确诊但未接受手术治疗的肾嗜酸细胞瘤患者的预后情况。
1998年1月至2004年4月,在我们中心进行的一系列148例肾肿瘤活检中,有15例显示为嗜酸细胞瘤。初始治疗为非手术治疗。我们报告了这些患者的随访情况以及这些嗜酸细胞瘤的病程。平均随访时间为404±20.9个月。
这些患者确诊时的平均年龄为57.6±14.4岁,肿瘤平均直径为3.49±2.43厘米,平均体积为62.3±135.4立方厘米。这15例患者中有6例接受了手术:4例行根治性肾切除术,2例行部分肾切除术。手术指征为初始肿瘤体积(n = 1)、肿瘤生长速度>0.5厘米/年(n = 4)以及患者的意愿(n = 1)。接受手术的患者更年轻(45.5±11.1岁 vs 65.6±10.3岁),确诊时肿瘤更大(50±30.1毫米 vs 27.3±10.5毫米)。所有9例接受观察等待治疗的患者均无症状。
嗜酸细胞瘤的自然病程似乎是肿瘤大小或多或少地快速增加。治疗可以是保守的。初始肿瘤体积或肿瘤快速生长是切除的指征。当肿瘤大小和位置允许时,部分肾切除术目前是首选技术。