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无体外循环下治疗伴有右心房肿瘤栓子的肾平滑肌肉瘤:一例报告

Treatment of renal leiomyosarcoma with right atrial tumor embolus without cardiopulmonary bypass: a case report.

作者信息

Duan Yuanpeng, Bi Chengwei, Zhang Guoying, Xing Yapeng, Qin Yang, Zhao Bin

机构信息

Department of Urology, the Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.

出版信息

Front Oncol. 2024 May 10;14:1385073. doi: 10.3389/fonc.2024.1385073. eCollection 2024.

Abstract

OBJECTIVE

To investigate the clinical manifestations, imaging and pathological features, treatment methods and prognosis of primary leiomyosarcoma of kidney, and the choice of treatment with tumor thrombus.

METHODS

The clinical data of a patient with primary renal leiomyosarcoma complicated with inferior vena cava and right atrial tumor thrombus were retrospectively analyzed. Radical resection of right kidney without cardiopulmonary bypass and removal of inferior vena cava and right atrial tumor thrombus were performed. Adjuvant intravenous chemotherapy was given according to the results, and follow-up observation was made.

RESULTS

Postoperative pathological findings were: leiomyosarcoma (right renal tumor), the size of the mass was about 12.1 cm, and no cancer was found at the incision end of the right ureter.

CONCLUSION

Primary leiomyosarcoma of kidney is rare in clinical practice, and complication of right atrial tumor embolus is even rarer. The disease has high malignant degree and poor prognosis. The clinical manifestations and imaging examinations were non-specific, and pathological diagnosis was the gold standard. Radical surgical resection is the main treatment method at present, and it provides experience for the treatment of grade IV tumor thrombus without cardiopulmonary bypass.

摘要

目的

探讨肾原发性平滑肌肉瘤的临床表现、影像学及病理特征、治疗方法及预后,以及合并肿瘤血栓时的治疗选择。

方法

回顾性分析1例原发性肾平滑肌肉瘤合并下腔静脉及右心房肿瘤血栓患者的临床资料。在非体外循环下行右肾根治性切除术,并切除下腔静脉及右心房肿瘤血栓。根据结果给予辅助静脉化疗,并进行随访观察。

结果

术后病理结果为:平滑肌肉瘤(右肾肿瘤),肿块大小约12.1 cm,右输尿管切端未见癌。

结论

肾原发性平滑肌肉瘤临床少见,合并右心房肿瘤栓子更为罕见。该疾病恶性程度高,预后差。临床表现及影像学检查无特异性,病理诊断为金标准。根治性手术切除是目前主要的治疗方法,为非体外循环下IV级肿瘤血栓的治疗提供了经验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa3a/11116682/706b12b1c2ab/fonc-14-1385073-g001.jpg

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