Minoda Ryo, Takagi Toshio, Toda Naohiro, Itagaki Hiroko, Kondo Tsunenori, Ishida Hideki, Nagashima Yoji, Tanabe Kazunari
Department of Urology, Tokyo Women's Medical University, Tokyo 162-8666, Japan.
Department of Surgical Pathology, Tokyo Women's Medical University, Tokyo 162-8666, Japan.
Mol Clin Oncol. 2017 Dec;7(6):1005-1007. doi: 10.3892/mco.2017.1444. Epub 2017 Oct 6.
Mixed epithelial and stromal tumor (MEST) of the kidney is a benign tumor occurring predominantly in older women. Histologically, MEST comprises tubuloglandular and cystic structures in an ovarian-like stroma. Bilateral and multiple cases are rare. We herein present a case of bilateral and multiple MEST in a 43-year-old woman. The patient presented with gross hematuria and was referred to a primary care physician. A computed tomography scan revealed 5 tumors in the right and 2 in the left kidney. Renal cell carcinoma was suspected, and left partial nephrectomy followed by right radical nephrectomy was planned. After the left partial nephrectomy, the histopathological diagnosis was MEST, which was consistent with the results obtained following needle biopsy. Therefore, the contralateral tumor was also suspected to be MEST, and needle biopsy was performed. The histopathological diagnosis was identical and the right kidney was spared. The patient is currently periodically monitored. As MEST is a benign tumor, preoperative diagnosis is crucial for avoiding overtreatment.
肾脏混合性上皮和间质肿瘤(MEST)是一种主要发生于老年女性的良性肿瘤。组织学上,MEST由类似卵巢间质的管状腺泡和囊性结构组成。双侧和多发病例罕见。我们在此报告一例43岁女性双侧多发MEST病例。患者出现肉眼血尿,转诊至初级保健医生处。计算机断层扫描显示右肾有5个肿瘤,左肾有2个肿瘤。怀疑为肾细胞癌,计划先行左肾部分切除术,随后行右肾根治性切除术。左肾部分切除术后,组织病理学诊断为MEST,与穿刺活检结果一致。因此,对侧肿瘤也怀疑为MEST,并进行了穿刺活检。组织病理学诊断相同,右肾得以保留。目前对该患者进行定期监测。由于MEST是良性肿瘤,术前诊断对于避免过度治疗至关重要。