妊娠晚期肾错构瘤破裂出血一例报告
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摘要
肾错构瘤是较常见的肾脏肿瘤,绝大部分为良性,体积较大时易破裂出血。但妊娠晚期并发肾错构瘤出血,且病理示肿瘤具有恶性潜能的案例报道极少。本文通过回顾分析收治的1例妊娠晚期肾错构瘤破裂出血的诊疗资料,给合文献,探讨妊娠期肾错构瘤出血的治疗。
Renal hamartoma is one of the most common renal tumors. Most of them are benign and tend to rupture and bleed when they are large. However,there are few cases of the late pregnancy complicated with renal hamartoma hemorrhage,and pathological evidence shows malignant potential. This article reviews and analyses the diagnosis and treatment data of one case of ruptured renal hamartoma in late pregnancy,and summarizes the literature to discuss the treatment of renal hamartoma hemorrhage.
Renal hamartoma is one of the most common renal tumors. Most of them are benign and tend to rupture and bleed when they are large. However,there are few cases of the late pregnancy complicated with renal hamartoma hemorrhage,and pathological evidence shows malignant potential. This article reviews and analyses the diagnosis and treatment data of one case of ruptured renal hamartoma in late pregnancy,and summarizes the literature to discuss the treatment of renal hamartoma hemorrhage.
引文
[1]徐祥云,傅斌,王共先,等.后腹腔镜不阻断肾蒂肾错构瘤切除术(附29例报告)[J].江西医药,2016,51(11):1136-1138.Xu XY,Fu B,Wang GX,et al.Retroperitoneal laparoscopic nonblocking renal pedicle hamartoma resection(report of 29 cases)[J].Jiangxi Med J,2016,51(11):1136-1138.doi:10.3969/j.issn.1006-2238.2016.11.002.
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[3]Morales JP,Georganas M,Khan MS,et al.Embolization of a bleeding renal angiomyolipoma in pregnancy:a case report and review[J].Cardiovasc Intervent Raqdiol,2005,28(2):265-268.doi:10.1007/s00270-004-1850-2.
[4]YU J,Astrinidis A,Howard S,et al.Estradiol and tamoxifen stimulate LAM-associated angiomyolipoma cell growth and activate both genomic and nongenomic signaling pathways[J].Am J Pathol,2003,162(3):491-500.doi:10.1152/ajplung.00204.2003.
[5]吉梅,林流芳,刘玉环,等.妊娠合并双肾巨大错构瘤及子宫血管周上皮样瘤剖宫产分娩1例报告[J].第二军医大学学报,2012,33(5):577-579.Ji M,Lin LF,Liu YH,et al.Pregnancy complicated with giant hamartoma of both kidneys and perivascular epithelioid tumors of uterus during cesarean section:a case report[J].Acad J Second Military Med Univ,2012,33(5):577-579.doi:10.3724/SP.J.1008.2012.00577.
[6]刘兆琼,傅斌,李兵才.泌尿外科腹腔镜手术236例分析[J].江西医药,2014,49(7):587.Liu ZQ,Fu B,Li BC.Analysis of 236cases of laparoscopic urology[J].Jiangxi Med J,2014,49(7):587.doi:10.3969/j.issn.1006-2238.2014.07.010.
[7]Komeya M,Matsumoto T,Fujinami K,et al.Rupture of renal angiomyolipoma during pregnancy:a case report[J].Hinyokika Kiyo,2010,56:261-264.
[8]谭公祥,熊海云,余明主,等.妊娠期肾血管平滑肌脂肪瘤自发性破裂1例报告并文献复习[J].南昌大学学报(医学版),2013,53(3):103-104.Tang GX,Xiong HY,Yu MZ,et al.Spontaneous rupture of renal angiomyolipoma during pregnancy:a case report and literature review[J].Acta Univ Med Nanchang(Medical Sciences),2013,53(3):103-104.doi:10.3969/j.issn.1000-2294.2013.03.030.
[9]邢力永,刘利维,刘春雨,等.超选择肾动脉栓塞术治疗肾错构瘤破裂出血的疗效观察[J].临床泌尿外科杂志,2015,30(11):1014-1016.Xing LY,Liu LW,Liu CY,et al.Superselective renal artery embolization for ruptured hemorrhage of renal hamartoma[J].J Clin Urology,2015,30(11):1014-1016.doi:10.13201/j.issn.1001-1420.2015.11.015.
[10]Eble JN,Sauter G,Epstein JI,et al.World Health Organization classification of tumors.Pathology and genetics of turnouts of the urinary system and male genital organs[M].Lyon:IARC Press,2004:64-69.
[11]石泓哲,李长岭,寿建忠,等.肾上皮样血管平滑肌脂肪瘤的诊治[J].中国癌症杂志,2013,23(3):207-210.Shi HZ,Li CL,Shou JZ,et al.Diagnosis and treatment of renal epithelioid angiomyolipoma[J].China Oncol,2013,23(3):207-210.doi:10.3969/j.issn.1007-3969.2013.03.009.
[12]Nese N,Martignoni G,Fletcher CD,et a1.Pure epithelioid PEComas(so-called epithelioid angiomyolipoma)of the kidney:a clinicopathologic study of 41 cases:detailed assessment of morphology and riskstraification stratification[J].Am J Surg Pathol,2011,35(5):161-176.doi:10.1097/PAS.0b013e318206f2a9.
[13]张俊,胡林昆,李聪,等.肾上皮样血管平滑肌脂肪瘤临床分析[J].中华泌尿外科杂志,2016,37(6):420-422.Zhang J,Hu LQ,Lin C,et al.Clinical analysis of renal epithelioid angiomyolipoma[J].Chin J Urol,2016,37(6):420-422.doi:10.3760/cma.j.issn.1000-6702.2016.06.006.
[14]陆文宝.转移性肾上皮样血管平滑肌脂肪瘤一例并文献复习[J].南昌大学学报(医学版),2015,55(1):103-104.Lu WB.Metastatic renal epithelioid angiomyolipoma:a case report and literature review[J].Acta Univ Med Nanchang(Medical Sciences),2015,55(1):103-104.doi:10.13764/j.cnki.ncdm.2015.01.031.
[15]Ao L,Ogasahara E,Okuda Y,et al.Spontaneous rupture of renal angiomyolipoma during pregnancy[J].BMJ Case Rep,2017,2017.doi:10.1136/bcr-2016-217284.2019-01-012019-05-28
[2]Konstantinos TG,Dimitrios T,Panagiotis KB,et al.Laparoscopicresection of an adrenal schwannoma[J].JSLS,2012,16(4):663-667.doi:10.4293/108680812X13517013316753.
[3]Morales JP,Georganas M,Khan MS,et al.Embolization of a bleeding renal angiomyolipoma in pregnancy:a case report and review[J].Cardiovasc Intervent Raqdiol,2005,28(2):265-268.doi:10.1007/s00270-004-1850-2.
[4]YU J,Astrinidis A,Howard S,et al.Estradiol and tamoxifen stimulate LAM-associated angiomyolipoma cell growth and activate both genomic and nongenomic signaling pathways[J].Am J Pathol,2003,162(3):491-500.doi:10.1152/ajplung.00204.2003.
[5]吉梅,林流芳,刘玉环,等.妊娠合并双肾巨大错构瘤及子宫血管周上皮样瘤剖宫产分娩1例报告[J].第二军医大学学报,2012,33(5):577-579.Ji M,Lin LF,Liu YH,et al.Pregnancy complicated with giant hamartoma of both kidneys and perivascular epithelioid tumors of uterus during cesarean section:a case report[J].Acad J Second Military Med Univ,2012,33(5):577-579.doi:10.3724/SP.J.1008.2012.00577.
[6]刘兆琼,傅斌,李兵才.泌尿外科腹腔镜手术236例分析[J].江西医药,2014,49(7):587.Liu ZQ,Fu B,Li BC.Analysis of 236cases of laparoscopic urology[J].Jiangxi Med J,2014,49(7):587.doi:10.3969/j.issn.1006-2238.2014.07.010.
[7]Komeya M,Matsumoto T,Fujinami K,et al.Rupture of renal angiomyolipoma during pregnancy:a case report[J].Hinyokika Kiyo,2010,56:261-264.
[8]谭公祥,熊海云,余明主,等.妊娠期肾血管平滑肌脂肪瘤自发性破裂1例报告并文献复习[J].南昌大学学报(医学版),2013,53(3):103-104.Tang GX,Xiong HY,Yu MZ,et al.Spontaneous rupture of renal angiomyolipoma during pregnancy:a case report and literature review[J].Acta Univ Med Nanchang(Medical Sciences),2013,53(3):103-104.doi:10.3969/j.issn.1000-2294.2013.03.030.
[9]邢力永,刘利维,刘春雨,等.超选择肾动脉栓塞术治疗肾错构瘤破裂出血的疗效观察[J].临床泌尿外科杂志,2015,30(11):1014-1016.Xing LY,Liu LW,Liu CY,et al.Superselective renal artery embolization for ruptured hemorrhage of renal hamartoma[J].J Clin Urology,2015,30(11):1014-1016.doi:10.13201/j.issn.1001-1420.2015.11.015.
[10]Eble JN,Sauter G,Epstein JI,et al.World Health Organization classification of tumors.Pathology and genetics of turnouts of the urinary system and male genital organs[M].Lyon:IARC Press,2004:64-69.
[11]石泓哲,李长岭,寿建忠,等.肾上皮样血管平滑肌脂肪瘤的诊治[J].中国癌症杂志,2013,23(3):207-210.Shi HZ,Li CL,Shou JZ,et al.Diagnosis and treatment of renal epithelioid angiomyolipoma[J].China Oncol,2013,23(3):207-210.doi:10.3969/j.issn.1007-3969.2013.03.009.
[12]Nese N,Martignoni G,Fletcher CD,et a1.Pure epithelioid PEComas(so-called epithelioid angiomyolipoma)of the kidney:a clinicopathologic study of 41 cases:detailed assessment of morphology and riskstraification stratification[J].Am J Surg Pathol,2011,35(5):161-176.doi:10.1097/PAS.0b013e318206f2a9.
[13]张俊,胡林昆,李聪,等.肾上皮样血管平滑肌脂肪瘤临床分析[J].中华泌尿外科杂志,2016,37(6):420-422.Zhang J,Hu LQ,Lin C,et al.Clinical analysis of renal epithelioid angiomyolipoma[J].Chin J Urol,2016,37(6):420-422.doi:10.3760/cma.j.issn.1000-6702.2016.06.006.
[14]陆文宝.转移性肾上皮样血管平滑肌脂肪瘤一例并文献复习[J].南昌大学学报(医学版),2015,55(1):103-104.Lu WB.Metastatic renal epithelioid angiomyolipoma:a case report and literature review[J].Acta Univ Med Nanchang(Medical Sciences),2015,55(1):103-104.doi:10.13764/j.cnki.ncdm.2015.01.031.
[15]Ao L,Ogasahara E,Okuda Y,et al.Spontaneous rupture of renal angiomyolipoma during pregnancy[J].BMJ Case Rep,2017,2017.doi:10.1136/bcr-2016-217284.2019-01-012019-05-28