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原发性肾类癌肿瘤:两例报告。

Primary Renal Carcinoid Tumor: Report of Two Cases.

作者信息

Jabaji Ramzi, Kern Tyler, Shen Dejun, Chu William, Merchant Madhur

机构信息

Department of Urology, Los Angeles Medical Center, CA.

Department of Pathology, Downey Medical Center, CA.

出版信息

Perm J. 2020;24. doi: 10.7812/TPP/19.147. Epub 2020 Mar 13.

Abstract

INTRODUCTION

Primary renal carcinoid tumors are a rare subset of neuroendocrine tumors arising in the kidneys. Although carcinoid syndrome has occasionally been described, most patients are asymptomatic at presentation.

CASE PRESENTATIONS

We present 2 cases of primary renal carcinoid tumor and describe the workup, immunohistochemical analysis, treatment, and surveillance of each female patient. The first patient was found to have a renal mass on imaging during a workup of chronic abdominal pain and subsequently underwent a robotic radical nephrectomy. The second patient was found to have an incidental renal mass on imaging and subsequently underwent renal biopsy, followed by robot-assisted laparoscopic partial nephrectomy. In both cases, a gallium dotatate Ga 68-enhanced positron emission tomography/computed tomography scan was used to further assess disease burden.

DISCUSSION

This report describes 2 cases of primary renal carcinoid tumor with unique presentations and management in our regional health care system. Because primary renal carcinoid tumors are quite uncommon, there are no clear established guidelines on preoperative imaging or posttreatment surveillance in patients with these tumors. There remains a large amount of variability in the diagnosis, workup, immunohistochemical analysis, treatment, and surveillance of patients with primary renal carcinoid tumors. As we learn more about this disease, we hope to optimize patient outcomes and standardize pretreatment workup and posttreatment surveillance.

摘要

引言

原发性肾类癌肿瘤是起源于肾脏的神经内分泌肿瘤中的一个罕见亚型。虽然偶尔会描述类癌综合征,但大多数患者在就诊时无症状。

病例报告

我们报告2例原发性肾类癌肿瘤病例,并描述每位女性患者的检查、免疫组化分析、治疗及监测情况。首例患者在慢性腹痛检查期间经影像学检查发现肾脏肿块,随后接受了机器人辅助根治性肾切除术。第二例患者经影像学检查偶然发现肾脏肿块,随后接受了肾活检,之后进行了机器人辅助腹腔镜肾部分切除术。在这两例病例中,均使用了镓[68Ga] DOTATATE 增强正电子发射断层扫描/计算机断层扫描来进一步评估疾病负担。

讨论

本报告描述了我们地区医疗保健系统中2例原发性肾类癌肿瘤的独特表现及处理情况。由于原发性肾类癌肿瘤相当罕见,对于这些肿瘤患者的术前影像学检查或治疗后监测尚无明确既定指南。原发性肾类癌肿瘤患者的诊断、检查、免疫组化分析、治疗及监测仍存在很大差异。随着我们对这种疾病了解得更多,我们希望优化患者预后并规范治疗前检查及治疗后监测。

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