Wang Shun, Liang Xiangyi, Pan Di, Zhang Jianqing, Chen Kun, Jiang Kehua, Li Tao
Department of Urology, Guizhou Provincial People's Hospital, Guiyang, China.
Zunyi Medical University, Zunyi, China.
Front Oncol. 2022 Oct 31;12:1027571. doi: 10.3389/fonc.2022.1027571. eCollection 2022.
The differential diagnosis of renal tumors and abscesses is crucial owing to their different treatments. Although antibacterial administration and radiological examination are excellent means for distinction, misdiagnosis is common and may lead to severe consequences, such as the need for nephrectomy. Here, we report a case involving a 52-year-old Asian woman with a renal mass for which a differential diagnosis was challenging. The mass persisted after administration of intravenous antibiotic therapy for 1 month. A computed tomography scan indicated an inflammatory lesion, whereas magnetic resonance imaging suggested a diagnosis of a tumor. Despite these indications, a right renal abscess was suspected during robot-assisted laparoscopic surgery, and nephron-sparing surgery was performed, which allowed confirmation of the final pathological result by biopsy specimen. Postoperatively, the mass gradually decreased in size after antibiotic therapy for a further month. This case, in which a renal abscess mimicked a tumor and the patient almost underwent a nephrectomy, highlights the need for caution in establishing therapeutic schedules for patients with inaccurate diagnoses. The management strategies for such patients must be reviewed and improved.
由于肾肿瘤和肾脓肿的治疗方法不同，对它们进行鉴别诊断至关重要。尽管抗菌治疗和影像学检查是很好的鉴别手段，但误诊很常见，可能会导致严重后果，比如需要进行肾切除术。在此，我们报告一例病例，患者为一名52岁的亚洲女性，其肾部有肿物，鉴别诊断颇具挑战性。静脉注射抗生素治疗1个月后，肿物依然存在。计算机断层扫描显示为炎性病变，而磁共振成像提示为肿瘤。尽管有这些检查结果，但在机器人辅助腹腔镜手术期间仍怀疑为右肾脓肿，并实施了保留肾单位手术，通过活检标本得以确认最终病理结果。术后，在进一步接受1个月的抗生素治疗后，肿物大小逐渐缩小。此例中，肾脓肿酷似肿瘤，患者差点接受肾切除术，这凸显了在为诊断不准确的患者制定治疗方案时需谨慎行事。必须重新审视并改进对此类患者的管理策略。
