Filianoti Alessio, Paganelli Aurelio, Bassi PierFrancesco, Simone Giuseppe, Ranieri Antonio
1 Clinic of Urology, Catholic University of Sacred Heart, Rome - Italy.
2 Department of Urology, ASST Bergamo Est, Bergamo - Italy.
Urologia. 2018 Feb;85(1):34-35. doi: 10.5301/uro.5000218.
Mesenchymal tumors are an exceptional finding in the urinary tract and renal leiomyoma is even more rare. They are usually discovered incidentally during ultrasonography examinations or autopsy. Sometimes they are clinically symptomatic with hematuria, flank pain, or palpable mass. Till today, it is still difficult to make a diagnosis of leiomyoma using the radiological examinations. Although conventional imaging has a high sensitivity and specificity in the detection of both retroperitoneal and renal masses, the diagnosis is based on histological examination, due to the poor discrimination accuracy between different retroperitoneal tumors.
We report a case of renal leiomyoma in a 47-year-old woman, who incidentally discovered a retroperitoneal mass with an abdominal ultrasound scheduled for a conventional follow-up schedule of a mammary neoplasm. Partial nephrectomy was carried out with an open flank surgical approach and the diagnosis was "leiomyoma of the renal capsule". Four years after surgery, the patient is disease-free.
Renal leiomyomas are rare, benign, nonmetastasizing tumors with a good prognosis after surgical treatment. At present, the differential diagnosis is still possible by histopathological examination.
间叶组织肿瘤在泌尿系统中是一种罕见的发现，肾平滑肌瘤则更为罕见。它们通常在超声检查或尸检时偶然被发现。有时临床上会出现血尿、侧腹疼痛或可触及肿块等症状。直到如今，通过放射学检查仍难以诊断平滑肌瘤。尽管传统成像在检测腹膜后和肾脏肿块方面具有较高的敏感性和特异性，但由于不同腹膜后肿瘤之间的鉴别准确性较差，诊断仍需基于组织学检查。
我们报告一例47岁女性肾平滑肌瘤病例，该患者在因乳腺肿瘤进行常规随访计划而进行腹部超声检查时偶然发现腹膜后肿块。采用开放侧腹手术入路进行了部分肾切除术，诊断为“肾包膜平滑肌瘤”。术后四年，患者无病生存。
肾平滑肌瘤是罕见的良性、无转移肿瘤，手术治疗后预后良好。目前，仍需通过组织病理学检查进行鉴别诊断。
