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肾胚细胞瘤样卵黄囊瘤临床误诊为肾母细胞瘤:一例报告。

Renal Yolk Sac Tumor Clinically Misdiagnosed as Nephroblastoma: A Case Report.

机构信息

Department of Pathology, First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, Gansu, China.

Department of Pathology, Chinese People's Liberation Army Joint Logistics Support Unit 940 Hospital, Lanzhou, Gansu, China.

出版信息

Fetal Pediatr Pathol. 2023 Jun;42(3):522-528. doi: 10.1080/15513815.2023.2166800. Epub 2023 Jan 16.

Abstract

Yolk sac tumor is a germ cell tumor (GCT) that occurs in infants and adolescents and affects various sites. There is a trend to treat pediatric renal tumors before a tissue diagnosis. We report a renal yolk sac tumor clinically misdiagnosed as Wilms tumor, based on ultrasound (US) and MRI. This 21-month-old male infant was discovered to have a space occupying lesion in the right kidney. Because the tumor was large, initial radiotherapy preceded surgical resection. Histologically, the tumor was a yolk sac tumor. Imaging examination of renal yolk sac tumor can easily be misdiagnosed as Wilms tumor. SIOP treatment plan for Wilms tumor requires preoperative chemotherapy, which is different from the treatment regimen for yolk sac tumor. Preoperative alpha-fetoprotein could have been helpful in avoiding this clinical misdiagnosis.

摘要

卵黄囊瘤是一种发生在婴儿和青少年的生殖细胞肿瘤(GCT),可发生于多个部位。儿科医生在进行组织诊断之前,有治疗肾肿瘤的趋势。我们报告了一例临床误诊为肾母细胞瘤的肾卵黄囊瘤,依据为超声(US)和 MRI。该 21 月龄男婴发现右肾占位性病变。由于肿瘤较大,首先进行了放疗,随后进行了手术切除。组织学检查结果为卵黄囊瘤。肾卵黄囊瘤的影像学检查很容易误诊为肾母细胞瘤。SIOP 肾母细胞瘤治疗方案需要术前化疗,与卵黄囊瘤的治疗方案不同。术前甲胎蛋白检查可能有助于避免这种临床误诊。

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