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与严重高血压相关的甲状腺滤泡癌样肾肿瘤的临床病理研究:病例报告及文献复习

Clinicopathological study on thyroid follicular carcinoma-like renal tumor related to serious hypertension: Case report and review of the literature.

作者信息

Wang Hui, Yu Jianpeng, Xu Zhonghua, Li Gang

机构信息

Department of Urology, Qilu Hospital of Shandong University, Jinan Department of Urology, Dezhou People Hospital, Dezhou City, Shandong Province Department of Urology, Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, He Xi District, Tianjin, China.

出版信息

Medicine (Baltimore). 2017 Mar;96(12):e6419. doi: 10.1097/MD.0000000000006419.

Abstract

RATIONALE

Thyroid carcinoma-like tumor of the kidney (TLFCK) is an extremely rare variant of renal cell carcinoma. Most cases were incidentally found, while we report the first case of TLFCK presented with hypertension.

PATIENT CONCERNS

A 25-year-old woman was admitted to our hospital presenting with hypertension for ∼20 months, without gross hematuria, weight loss, and flank pain.

DIAGNOSES

Imaging studies revealed a right renal mass with multiple calcifications. Histologically, the tumor had striking follicles with dense, colloid-like material resembling thyroid follicular carcinoma while the tumor cells were negative for thyroid markers (thyroglobulin and thyroid transcription factor-1).

INTERVENTIONS

The patient successfully underwent nephron sparing surgery with an uneventful recovery.

OUTCOMES

Hypertension returned to normal without any medication interference. Two years after surgery, the patient is still in good health without recurring disease or related hypertension.

LESSONS

Recognition of the cytomorphological features of TLFCK can avoid misdiagnosis of this renal tumor as a metastatic carcinoma and the objective of surgical management is to remove the tumor and preserve renal function.

摘要

原理

肾甲状腺癌样肿瘤(TLFCK)是肾细胞癌的一种极其罕见的变异型。大多数病例是偶然发现的,而我们报告了首例表现为高血压的TLFCK病例。

患者情况

一名25岁女性因高血压约20个月入院,无肉眼血尿、体重减轻和侧腹痛。

诊断

影像学检查发现右肾肿块伴多发钙化。组织学上,肿瘤有明显的滤泡,内含致密的、类似胶体的物质,类似甲状腺滤泡癌,但肿瘤细胞的甲状腺标志物(甲状腺球蛋白和甲状腺转录因子-1)呈阴性。

干预措施

患者成功接受了保留肾单位手术,恢复顺利。

结果

高血压在未使用任何药物干预的情况下恢复正常。术后两年,患者仍健康良好,无疾病复发及相关高血压。

经验教训

认识TLFCK的细胞形态学特征可避免将这种肾肿瘤误诊为转移性癌,手术治疗的目的是切除肿瘤并保留肾功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d198/5371481/3fc141f5803c/medi-96-e6419-g001.jpg

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