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良性肾血管平滑肌脂肪瘤伴下腔静脉血栓形成。

Benign renal angiomyolipoma with inferior vena cava thrombosis.

机构信息

Department of Urology and Transplant, Dayanand Medical College, Ludhiana, Punjab, India.

出版信息

Urology. 2011 Jun;77(6):1503-6. doi: 10.1016/j.urology.2011.01.039. Epub 2011 Apr 13.

Abstract

OBJECTIVE

To present a new case of an uncommon complication of a benign renal tumor. To our knowledge, there are only few published cases of benign renal angiomyolipoma (AML) presenting with tumor thrombus in females. Epithelioid angiomyolipoma is a recently described rare variant of renal angiomyolipoma. It can occur in patients with or without tuberous sclerosis, and may potentially be malignant. Benign renal angiomyolipoma AML rarely presents with evidence of extension into the renal vein, inferior vena cava (IVC) or atrium. We report a case of a benign renal AML with a tumor thrombus to the IVC in a 46-year-old female who presented with right-sided flank pain associated with a right sided abdominal mass.

METHODS

Right Radical nephrectomy with IVC tumor thrombectomy.

RESULTS

Patient is totally asymptomatic. At 1 month after surgery, an abdominal ultrasound showed no evidence of thrombus within the IVC. CT scan of the abdomen at 3 months post-operatively showed no evidence of recurrence.

CONCLUSION

Surgical treatment of angiomyolipoma with IVC thrombus is warranted in view of risk of malignancy and to prevent tumor embolus to the heart or lungs.

摘要

目的

介绍一种良性肾肿瘤罕见并发症的新病例。据我们所知,仅有少数关于女性良性肾血管平滑肌脂肪瘤(AML)伴发肿瘤血栓的病例报道。上皮样血管平滑肌脂肪瘤是一种最近描述的肾脏血管平滑肌脂肪瘤的罕见变异型。它可发生于有或无结节性硬化症的患者中,且可能具有恶性潜能。良性肾血管平滑肌脂肪瘤 AML 很少出现侵犯肾静脉、下腔静脉(IVC)或心房的证据。我们报告了一例 46 岁女性的良性肾 AML 伴 IVC 肿瘤血栓形成的病例,该患者表现为右侧腰痛伴右侧腹部肿块。

方法

行右肾根治性切除术及 IVC 肿瘤血栓切除术。

结果

患者完全无症状。术后 1 个月,腹部超声检查未见 IVC 内血栓形成。术后 3 个月的腹部 CT 扫描未见复发证据。

结论

鉴于恶性风险和防止肿瘤栓子进入心脏或肺部的风险,有必要对伴有 IVC 血栓的血管平滑肌脂肪瘤进行手术治疗。

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