Department of Surgical Oncology.
Department of Pathology, The Children's Hospital, Zhejiang University School Of Medicine, National Clinical Research Center For Child Health, Hangzhou, China.
Medicine (Baltimore). 2021 Jan 15;100(2):e23717. doi: 10.1097/MD.0000000000023717.
Renal cell carcinoma (RCC) is infrequent in the pediatric population. In addition, till date, only a few reports have summarized the characteristics of pediatric RCC and differences between pediatric and adult RCC. Therefore, the current study aimed to investigate the clinical characteristics of RCC in children and adolescents, and identify the differences between children and adolescent patients and adult patients through literature retrieval.The data of 13 pediatric patients diagnosed with RCC at the Children's Hospital of Zhejiang University School of Medicine between 2005 and 2019 were retrospectively analyzed.Three patients were aged <5 years, 2 were aged 6 to 10 years, and 8 were aged 11 to 18 years. Among the 13 patients, common clinical manifestations included abdominal pain in 5 patients, gross hematuria in 4, and an abdominal mass in 1, while the other 3 patients were incidentally detected after an abdominal contusion. The pathological types were microphthalmia family translocation RCC in 9 patients, clear-cell RCC in 2, papillary RCC in 1, and unclassified in 1. All the children underwent radical nephrectomy, including 2 patients with advanced disease who underwent preoperative transcatheter arterial chemoembolization. The mean follow-up time was 58.6 months. Two patients died after 4 and 17 months of follow-up, respectively.In conclusion, microphthalmia family translocation renal cell carcinoma is the predominant type of pediatric RCC associated with advanced tumor stage. The early diagnosis and treatment of pediatric patients is important for improving prognosis. Nevertheless, future studies are urgently needed to determine the treatment for pediatric advanced RCC to increase the survival rate.
肾细胞癌(RCC)在儿科人群中较为少见。此外,迄今为止,仅有少数报道总结了小儿 RCC 的特征以及小儿 RCC 与成人 RCC 之间的差异。因此,本研究旨在通过文献检索探讨儿童和青少年 RCC 的临床特征,并确定儿童和青少年患者与成年患者之间的差异。
回顾性分析 2005 年至 2019 年期间在浙江大学医学院附属儿童医院诊断为 RCC 的 13 例儿科患者的数据。3 例患者年龄<5 岁,2 例患者年龄为 6-10 岁,8 例患者年龄为 11-18 岁。13 例患者中,常见的临床表现包括 5 例腹痛、4 例肉眼血尿和 1 例腹部肿块,而另外 3 例患者是在腹部挫伤后意外发现的。病理类型包括 9 例小眼畸形家族易位 RCC、2 例透明细胞 RCC、1 例乳头状 RCC 和 1 例未分类。所有儿童均接受根治性肾切除术,其中 2 例晚期疾病患者接受术前经导管动脉化疗栓塞术。平均随访时间为 58.6 个月。2 例患者分别在随访 4 个月和 17 个月后死亡。
总之,小眼畸形家族易位肾细胞癌是小儿 RCC 的主要类型,与肿瘤晚期相关。早期诊断和治疗小儿患者对于改善预后非常重要。然而,目前迫切需要开展研究来确定小儿晚期 RCC 的治疗方法,以提高生存率。