Terao Hideyuki, Matsumoto Tatsuya, Umemoto Susumu, Onuki Tatsuaki, Kobayashi Kazuki, Ohgo Yoshiharu, Nogcchi Sumio, Kishi Hiroichi, Tsuura Yukio, Nagashima Yoji
Department of Urology, Yokosuka Kyosai Hospital.
Hinyokika Kiyo. 2008 Sep;54(9):599-602.
We report 2 cases of metanephric adenoma a rare form of adenoma. One case occurred in a 54-year-old male preoperatively diagnosed with renal cell carcinoma who underwent left partial nephrectomy for a tumor 2 cm in size. Histology revealed a tumor with papillotubular structures consisting of small, uniform tumor cells. In immunohistochemical staining, tumor cells were positive for CD57 and WT-1. Thus, the patient was diagnosed with metanephric adenoma. The other case occurred in a 40-year-old male who underwent left nephroureterectomy for carcinoma of the renal pelvis. Carcinoma of the left renal pelvis was diagnosed as pT3N0M0. Incidental micronodules 2 mm in size and consisting of immature tubular structures were noted in the renal cortex. In immunohistochemical staining, tumor cells were positive for CD57 and WT-1, and the patient was diagnosed with metanephric adenoma. The aforementioned tumors frequently occur in middle-aged women and are often well-defined tumors that project from the renal surface outwards. On angiography, they have a hypovascular pattern and resemble papillary renal carcinoma. Preoperative differentiation of renal cell carcinoma and nephroblastoma is difficult. Mistaking such tumors for malignant tumors and subjecting patients to unnecessary adjuvant therapy must be avoided.
我们报告2例后肾腺瘤，这是一种罕见的腺瘤类型。1例发生在一名54岁男性身上，术前诊断为肾细胞癌，因2厘米大小的肿瘤接受了左肾部分切除术。组织学检查显示肿瘤具有乳头管状结构，由小而均匀的肿瘤细胞组成。免疫组化染色显示，肿瘤细胞CD57和WT-1呈阳性。因此，该患者被诊断为后肾腺瘤。另一例发生在一名40岁男性身上，他因肾盂癌接受了左肾输尿管切除术。左肾盂癌被诊断为pT3N0M0。在肾皮质中发现了偶然的2毫米大小、由不成熟管状结构组成的小结节。免疫组化染色显示，肿瘤细胞CD57和WT-1呈阳性，该患者被诊断为后肾腺瘤。上述肿瘤常见于中年女性，通常是从肾表面向外突出的边界清晰的肿瘤。血管造影显示，它们具有少血管模式，类似乳头状肾癌。肾细胞癌和肾母细胞瘤的术前鉴别诊断困难。必须避免将此类肿瘤误诊为恶性肿瘤并让患者接受不必要的辅助治疗。
