Richaud C, Breton F, Jean P
J Urol (Paris). 1984;90(2):135-8.
The authors report a case of cystic form of carcinoma of the kidney in a patient who also had a bladder tumour which could have explained the presenting symptom of haematuria. It was the discordance between echotomography and CT scan findings which led the authors to explore the patient surgically. A reassuring result of a frozen section biopsy led to partial nephrectomy even though the cystic mass had thick walls and serosanguinous contents. The actual diagnosis was corrected within 24 hours by the histopathologists who reported a clear cell renal carcinoma. The authors performed an extended nephrectomy which revealed the presence of some malignant cells in the remaining renal fragment. They take this opportunity to review the general problem of the association of carcinoma of the kidney and renal cyst. This case shows how hazardous may be the answer given from frozen section biopsy of a cystic mass in the kidney and how dangerous it is to perform a partial nephrectomy which may leave tumour tissue in place.
作者报告了一例肾囊性癌病例,该患者同时患有膀胱肿瘤,这可能解释了其血尿的首发症状。正是超声断层扫描和CT扫描结果之间的不一致,促使作者对患者进行手术探查。尽管囊性肿块壁厚且含有血性液体,但冰冻切片活检结果令人放心,于是进行了部分肾切除术。组织病理学家在24小时内修正了实际诊断,报告为透明细胞肾细胞癌。作者随后进行了扩大肾切除术,结果显示剩余肾组织中有一些恶性细胞。他们借此机会回顾了肾细胞癌与肾囊肿关联的一般问题。该病例表明,肾脏囊性肿块的冰冻切片活检结果可能存在风险,而进行可能会残留肿瘤组织的部分肾切除术是多么危险。