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Renal Leiomyosarcoma, a Rare Presentation 肾脏平滑肌肉瘤,一种罕见的表现
IF 1.6 Q3 ONCOLOGY Pub Date : 2022-03-21 DOI: 10.15586/jkcvhl.v9i1.216
T. Djiwa, K. Sabi, P. Simgban, Mayi Bombonne, B. Sama, Mazamaesso Tchaou, T. Darré
Renal sarcomas are very rare malignant tumours with a very poor prognosis. Renal leiomyosarcoma, a malignant tumour of smooth muscle origin, is the most common histological type. The article reports a case of leiomyosarcoma of renal location, with a review of the literature. A 38-year-old female patient, with no previous pathological history, consulted the nephrology department of the Teaching Hospital of Lomé for abdominal pain that had been present for 4 years. Histology showed a tumour proliferation of fasciculated architecture, made of spindle cells arranged in long bundles, with cytonuclear atypia and cytoarchitectural abnormalities. Immunohistochemical examination showed positive staining for smooth muscle actin, h-caldesmone, desmin and CD34 and negative for pancytokeratin (AE1/AE3), myogenin and PS100. Renal leiomyosarcoma is an exceptional malignancy. It remains the most common renal sarcoma, the differential diagnosis of which is based on immunohistochemical findings.
肾肉瘤是一种非常罕见的恶性肿瘤,预后很差。肾平滑肌肉瘤是一种起源于平滑肌的恶性肿瘤,是最常见的组织学类型。本文报告1例肾脏部位平滑肌肉瘤,并复习文献。38岁女性患者,既往无病理史,因腹痛4年就诊lomoise教学医院肾脏病科。组织学显示肿瘤呈束状结构增生,由长束排列的梭形细胞组成,具有细胞核异型性和细胞结构异常。免疫组化检查显示平滑肌肌动蛋白、h- caldesmoone、desmin和CD34阳性,全细胞角蛋白(AE1/AE3)、肌原蛋白和PS100阴性。肾平滑肌肉瘤是一种罕见的恶性肿瘤。它仍然是最常见的肾肉瘤,其鉴别诊断是基于免疫组织化学结果。
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引用次数: 1
Inflammatory Hibernoma of the Renal Hilum Mimicking a Renal Pelvis Tumor 类似肾盂肿瘤的肾门炎性冬眠瘤
IF 1.6 Q3 ONCOLOGY Pub Date : 2022-03-16 DOI: 10.15586/jkcvhl.v9i1.225
Kelsey Larkin, Kevin J. Chua, S. Doppalapudi, Colton Smith, Evita T. Sadimin, V. Fitzhugh, E. Singer
We report on an enhancing, heterogenous renal pelvis mass growing over 2 years which was found to be a benign hibernoma with inflammatory and lipomatous features originating from the renal hilum. To our knowledge, this is the first case reported on a hibernoma compressing on the renal pelvis and second case of a hibernoma with the inflammatory variant.
我们报告一个生长超过2年的增强的异质肾盂肿块,被发现是一种良性冬眠瘤,具有起源于肾门的炎症和脂肪瘤特征。据我们所知,这是第一例报告的压迫肾盂的冬眠瘤和第二例伴有炎症变异体的冬眠瘤。
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引用次数: 0
Spectrum of Presentations and Management Strategies in Renal Angiomyolipoma. 肾血管肌脂肪瘤的表现范围和处理策略
IF 1.6 Q3 ONCOLOGY Pub Date : 2022-01-28 eCollection Date: 2022-01-01 DOI: 10.15586/jkcvhl.v9i1.221
Sinan Khaddam, Shuchi Gulati

Renal angiomyolipoma (rAML) occurs rarely sporadically but is commonly encountered in patients with tuberous sclerosis complex and lymphangioleiomyomatosis. rAML is a rare entity, not seen regularly in daily practice; however, is commonly encountered and diagnosed by clinicians who approach and treat kidney masses. Basic knowledge of this entity is necessary to recognize that despite being benign, these tumors can rarely cause deadly complications such as hemorrhage or severe renal dysfunction or may have malignant components associated with them.

肾血管肌脂肪瘤(rAML)很少偶发,但常见于结节性硬化症复合体和淋巴管瘤病患者。rAML 是一种罕见的肿瘤,在日常诊疗中并不常见,但临床医生在处理和治疗肾脏肿块时经常会遇到并诊断出这种肿瘤。要认识到这些肿瘤尽管是良性的,但在极少数情况下会引起致命的并发症,如出血或严重的肾功能障碍,或可能伴有恶性成分,就必须对这种肿瘤有基本的了解。
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引用次数: 0
New Trends and Evidence for the Management of Renal Angiomyolipoma: A Comprehensive Narrative Review of the Literature. 肾血管平滑肌脂肪瘤治疗的新趋势和新证据:文献综述。
IF 1.6 Q3 ONCOLOGY Pub Date : 2022-01-21 eCollection Date: 2022-01-01 DOI: 10.15586/jkcvhl.v9i1.177
Juan Camilo Álvarez Restrepo, David Andres Castañeda Millan, Carlos Andres Riveros Sabogal, Andres Felipe Puentes Bernal, Wilfredo Donoso Donoso
Treatment of renal angiomyolipoma (AML) seeks to reduce related complications and preserve kidney function. The purpose of this article was to perform an updated literature review on the diagnosis, therapeutic options, and criteria for invasive intervention in patients with renal AML. Computerized tomography is the standard diagnostic method for renal AML, while definitive diagnosis is made by histopathology. The management of choice in most cases is active surveillance (AS), with a clinical and imaging follow-up protocol. In high-risk cases, therapeutic management should be considered, with alternatives such as selective arterial embolization (SAE), nephron-sparing surgery (NSS), and mTOR inhibitors in selected patients. Renal AML in women of childbearing age, those with growth >0.25 cm/year, intralesional aneurysms >5 mm, and clinically significant symptoms may qualify for active treatment. Despite the limitations derived from the available evidence, it is possible to consider SAE, NSS, and the use of mTOR inhibitors as management alternatives for selected patients.
肾血管平滑肌脂肪瘤(AML)的治疗旨在减少相关并发症和保持肾功能。本文的目的是对肾性急性髓性白血病患者的诊断、治疗选择和侵入性干预标准进行最新的文献综述。计算机断层扫描是肾性急性髓性白血病的标准诊断方法,而明确的诊断是通过组织病理学。在大多数情况下,选择的管理是主动监测(AS),并有临床和影像学随访协议。在高危病例中,应考虑治疗性管理,选择选择性动脉栓塞(SAE)、保留肾元手术(NSS)和mTOR抑制剂等替代方案。育龄妇女肾性AML,生长>0.25 cm/年,瘤内动脉瘤> 5mm,临床症状显著者可能有资格接受积极治疗。尽管现有证据存在局限性,但可以考虑将SAE、NSS和mTOR抑制剂作为选定患者的管理选择。
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引用次数: 6
Inflammatory Myofibroblastic Tumor of the Right Kidney Mimicking a Locally Advanced Renal Carcinoma: A Case Report. 模拟局部晚期肾癌的右肾炎性肌纤维母细胞瘤1例。
IF 1.6 Q3 ONCOLOGY Pub Date : 2022-01-01 DOI: 10.15586/jkcvhl.v9i4.238
Ali Ariafar, Faisal Ahmed, AbdolAzim Khorshidi, Simin Torabi-Nezhad, Seyed Hossein Hosseini
An inflammatory myofibroblastic tumor (IMT) is a rare neoplasm with an unclear origin that can arise anywhere on the body. It contains spindle cells (myofibroblasts) with different inflammatory elements. Primary IMT of the kidney is a clinically rare disease and is difficult to differentiate from other renal malignancies. We reported a 49-year-old male who presented with right flank pain in the past year. A computed tomography scan showed a mixed density with slight heterogeneous enhancement mass in the upper pole of the right kidney, two small hypodense nodules invading the liver, and another mass in the lateral aspect of inferior vena cava. The patient underwent right radical nephrectomy and metastasectomy. IMT was confirmed by both postoperative histopathological examination and immunohistochemical assay. The patient recovered well after the operation, and no recurrence or metastasis was noted during the 12-month follow-up.
炎症性肌纤维母细胞瘤是一种罕见的肿瘤,起源不明,可发生在身体的任何部位。它含有梭形细胞(肌成纤维细胞),具有不同的炎症因子。原发性肾脏IMT是临床上罕见的疾病,很难与其他肾脏恶性肿瘤鉴别。我们报告了一名49岁的男性,他在过去的一年里出现了右侧疼痛。计算机断层扫描显示右肾上极有轻度不均匀强化的混合密度肿块,两个小的低密度结节侵入肝脏,下腔静脉外侧有另一个肿块。患者行右侧根治性肾切除术及转移性肾切除术。术后组织病理学检查和免疫组织化学检测均证实为IMT。患者术后恢复良好,随访12个月无复发或转移。
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引用次数: 2
Primary Chondrosarcoma in L-shaped Crossed Fused Renal Ectopia Coexisting with Papillary Urothelial Carcinoma in Urinary Bladder - An Enigmatic Entity with Poor Prognosis. l型交叉融合肾异位的原发性软骨肉瘤与膀胱乳头状尿路上皮癌共存-一种预后不良的神秘实体。
IF 1.6 Q3 ONCOLOGY Pub Date : 2022-01-01 DOI: 10.15586/jkcvhl.v9i1.162
Mayank Kumar, Aasma Nalwa, Taruna Yadav, Poonam Elhence, Himanshu Pandey, Meenakshi Rao

Primary renal chondrosarcomas are rare tumors that are high-grade in nature and, unfortunately, have poorly understood pathogenesis and extremely low prognosis. The coexistence of a discrete malignancy in the urinary bladder is even rarer, with the occurrence of distinct papillary urothelial carcinoma in the urinary bladder in this case. The clinical presentation is nonspecific, and the primary radiological investigations have a limited scope in providing specific diagnosis of this entity. The final diagnosis is possible on thorough histopathological examination of the resected specimen, which requires extensive sampling and meticulous reporting. As of now, the only way to achieve a better prognosis is by early diagnosis. It is necessary to keep the possibility of occurrence of sarcomas at rare sites in the differential diagnoses. The cytogenetic and molecular abnormalities associated with this entity need to be elucidated to achieve a more satisfactory outcome concerning the overall management of the patient.

原发性肾软骨肉瘤是一种罕见的高级别肿瘤,不幸的是,其发病机制尚不清楚,预后极低。单独的恶性肿瘤在膀胱中共存的情况更罕见,在本病例中,膀胱中出现明显的乳头状尿路上皮癌。临床表现是非特异性的,主要的放射学检查在提供这种实体的具体诊断方面具有有限的范围。最终诊断是可能的彻底的组织病理学检查切除标本,这需要广泛的抽样和细致的报告。到目前为止,获得更好预后的唯一方法是早期诊断。在鉴别诊断时,应注意罕见部位发生肉瘤的可能性。需要阐明与该实体相关的细胞遗传学和分子异常,以便在患者的整体管理方面取得更令人满意的结果。
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引用次数: 0
High-Resolution Ultrasonography of Renal Oncocytoma Presenting with Symptomatic Hematuria and Urinary Bladder Clot Retention-A Rare Occurrence. 以症状性血尿和膀胱血栓潴留为表现的肾嗜瘤瘤的高分辨率超声检查——罕见的病例。
IF 1.6 Q3 ONCOLOGY Pub Date : 2022-01-01 DOI: 10.15586/jkcvhl.v9i1.200
Reddy Ravikanth

Renal oncocytomas are asymptomatic, benign tumors often encountered incidentally on various imaging modalities. Renal oncocytomas comprise 5-7% of primary renal neoplasms and are derived from cells of the distal renal tubule. We present a case report of renal oncocytoma in a 22-year-old male having right-sided flank pain and symptomatic gross hematuria with a giant urinary bladder clot retention. The tumor was excised, and the patient underwent laparoscopic partial nephrectomy. Typical features of renal oncocytoma were observed upon histopathological examination of the resected specimen. The patient was catheterized, and bladder irrigation with clot retraction was performed.

肾嗜瘤细胞瘤是一种无症状的良性肿瘤,经常在各种影像学检查中偶然发现。肾癌细胞瘤占原发性肾肿瘤的5-7%,起源于远端肾小管细胞。我们报告一例22岁男性肾嗜酸细胞瘤患者,有右侧腹部疼痛和明显的血尿症状,并伴有巨大的膀胱血块潴留。肿瘤被切除,病人接受腹腔镜部分肾切除术。对切除标本进行组织病理学检查,发现肾嗜瘤细胞瘤的典型特征。患者接受导尿管置管,并行膀胱冲洗和血块收回术。
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引用次数: 2
Von Hippel-Lindau Syndrome: Medical Syndrome or Surgical Syndrome? A Surgical Perspective. 冯希佩尔-林道综合征:内科综合征还是外科综合征?外科视角。
IF 1.6 Q3 ONCOLOGY Pub Date : 2021-12-05 eCollection Date: 2022-01-01 DOI: 10.15586/jkcvhl.v9i1.206
Danilo Coco, Silvana Leanza

Von Hippel-Lindau syndrome (VHL) is an autosomal dominant disease caused by a genetic aberration of the tumor suppressor gene VHL and characterized by multi-organ tumors. The most common neoplasm is retinal or cerebral hemangioblastoma, although spinal hemangioblastomas, Renal Clear Cell Carcinoma (RCCC), pheochromocytomas (Pheo), paragangliomas, Pancreatic Neuroendocrine Tumors (PNETs), cystadenomas of the epididymis, and tumors of the lymphatic sac can also be found. Neurological complications from retinal or CNS hemangioblastoma and metastases of RCCC are the most common causes of death. There is a strong association between pheochromocytoma and VHL syndrome, and pheochromocytoma is often a classic manifestation of the syndrome. RCCCs are often incidental and identified during other tests. Between 35 and 70% of patients with VHL have pancreatic cysts. These can manifest as simple cysts, serous cysto-adenomas, or PNETs with a risk of malignant degeneration or metastasis of no more than 8%. The objective of this retrospective study is to analyze abdominal manifestations of VHL from a surgical point of view.

Von Hippel-Lindau综合征(VHL)是由肿瘤抑制基因VHL的遗传畸变引起的常染色体显性疾病,以多器官肿瘤为特征。最常见的肿瘤是视网膜或脑血管母细胞瘤,尽管脊柱血管母细胞瘤、肾透明细胞癌(RCCC)、嗜铬细胞瘤(Pheo)、副神经节瘤、胰腺神经内分泌肿瘤(PNETs)、附睾囊腺瘤和淋巴囊肿瘤也可以发现。视网膜或中枢神经系统血管母细胞瘤和RCCC转移引起的神经系统并发症是最常见的死亡原因。嗜铬细胞瘤与VHL综合征有很强的相关性,嗜铬细胞瘤往往是该综合征的典型表现。RCCCs通常是偶然发生的,并在其他测试中被识别出来。35% - 70%的VHL患者有胰腺囊肿。表现为单纯性囊肿、浆液性囊腺瘤或PNETs,发生恶性变性或转移的风险不超过8%。本回顾性研究的目的是从外科角度分析VHL的腹部表现。
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引用次数: 6
Examining the Relationship between Depression, Anxiety and Stress in Kidney Cancer Patients 肾癌患者抑郁、焦虑和应激关系的研究
IF 1.6 Q3 ONCOLOGY Pub Date : 2021-11-28 DOI: 10.15586/jkcvhl.v9i1.199
T. Demirtas, Zekeriya Temircan
Cancer of the kidney is one of the 10 most common cancers found globally. Overall, it is the fourth most common cancer in men and the eighth most common cancer in women. Many kidney cancer patients experience psychologic problems and reactions. The present study examined relationship between anxiety, depression, and perceived stress symptoms in kidney cancer patients. Cross-sectional data were obtained from the patients diagnosed with kidney cancer. All participants completed sociodemographic form, Hospital Anxiety and Depression form, and Perceived Stress Scale. Statistical analysis was exercised using the Student’s t-test, Chi-squared test (χ2), Fischer’s exact test, ANOVA, Mann–Whitney U test, and Kruskal–Wallis one-way variance analysis. A total of 250 patients participated in the study. The mean age was 57.4 years (SD 6.4, range = 25–76 years). The majority of patients were males (73%) and married (218). Anxiety symptoms were determined in 91.2% patients, depression symptoms in 87.2% patients, and perceived stress symptoms in 93.6% patients. The mean scores of Hospital Depression and Anxiety Scale (HADS)-Anxiety, HADS-Depression, and HADS-Perceived Stress were significantly different between age (P < 0.05), gender (P < 0.05), and income groups (P < 0.001). Kidney cancer patients showed poorer psychologic health. The overall levels of anxiety, depression, and perceived stress symptoms were higher among the studied kidney cancer patients. Findings of the current study could improve both psychologic well-being of patients and health-related quality of life.
癌症肾脏是全球发现的10种最常见的癌症之一。总体而言,它在男性中是第四常见的癌症,在女性中是第八常见的癌症。许多癌症患者经历了心理问题和反应。本研究调查了癌症患者焦虑、抑郁和压力症状之间的关系。交叉截面数据是从诊断为癌症的患者中获得的。所有参与者都填写了社会人口统计表、医院焦虑和抑郁表以及感知压力量表。使用Student t检验、卡方检验(χ2)、Fischer精确检验、ANOVA、Mann–Whitney U检验和Kruskal–Wallis单向方差分析进行统计分析。共有250名患者参与了这项研究。平均年龄为57.4岁(标准差6.4,范围=25-76岁)。大多数患者为男性(73%)和已婚(218)。91.2%的患者出现焦虑症状,87.2%的患者发现抑郁症状,93.6%的患者发现感知压力症状。医院抑郁和焦虑量表(HADS)-焦虑、HADS-抑郁和HADS-感知压力的平均分在年龄组、性别组和收入组之间有显著差异(P<0.05),癌症患者的心理健康状况较差。癌症患者的焦虑、抑郁和压力症状的总体水平较高。目前的研究结果可以改善患者的心理健康和健康相关的生活质量。
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引用次数: 4
The Benign Renal Masses that Were Exposed after Nephron-Sparing Surgery: "Postsurgical Fatty Tumor." Is It Related to the Surgical Technique? 保留肾脏手术后暴露的良性肾肿块:“术后脂肪瘤”。与手术技术有关吗?
IF 1.6 Q3 ONCOLOGY Pub Date : 2021-11-28 eCollection Date: 2022-01-01 DOI: 10.15586/jkcvhl.v9i1.195
Mehmet Balasar, Mehmet Serkan Özkent, Arif Aydin, Hakan Hakkı Taskapu, Ahmet Atici, Gokhan Ecer, Mehmet Giray Sonmez

After nephron-sparing surgery (NSS), postsurgical fatty tumor could be mistakenly reported as angiomyolipoma during radiologic imaging of some patients. In the present paper, we studied the postsurgical fatty tumor detected after NSS but not covered before in the literature. In addition, we also evaluated whether the postsurgical fatty tumor was related to the surgical technique employed. Patients admitted to the urology department of our university hospital from 2014 to 2019 and operated with open NSS were evaluated retrospectively. We detected those 156 patients were operated with NSS. Nine patients with angiomyolipoma as primary pathology and four patients with surgical border positivity were excluded from the study. The patients were divided into two groups based on the repair of tumor extraction region. In Group 1, fatty tissue was used for repair, and Group 2 is the primary repair group. In all, 143 patients (Group 1 = 79, and Group 2 = 64) were included in the study. No demographic and radiologic differences, such as number of patients, age, gender, positioning of tumor, mass localization, tumor diameter, and RENAL nephrometry scoring system, were detected between the two groups. Postsurgical fatty tumors were detected in 28 patients in Group 1 and in two patients in Group 2 (P < 0.001). In patients with negative surgical margins after partial nephrectomy, lesions that were radiologically detected mimicking as angiomyolipoma were defined as "postsurgical fatty tumor." This mass containing adipose tissue only neither depicted vascularization and enhancement nor increase in size for at least 1 year. We assumed that these lesions must be followed as benign lesions not requiring additional treatment.

部分患者在肾保留手术(NSS)后,术后脂肪瘤在影像学上可能被误报为血管平滑肌脂肪瘤。在本文中,我们研究了NSS后发现的术后脂肪瘤,但在文献中没有涉及。此外,我们还评估了术后脂肪瘤是否与所采用的手术技术有关。回顾性评价2014 - 2019年我院泌尿外科收治的开放性NSS患者。156例患者行NSS手术。9例原发病理为血管平滑肌脂肪瘤的患者和4例手术边界阳性的患者被排除在研究之外。根据肿瘤拔除区修复情况将患者分为两组。第1组采用脂肪组织修复,第2组为主要修复组。共纳入143例患者(组1 = 79,组2 = 64)。两组在患者人数、年龄、性别、肿瘤位置、肿块定位、肿瘤直径、肾肾测量评分系统等人口学和放射学方面均无差异。1组28例术后发现脂肪瘤,2例术后发现脂肪瘤(P < 0.001)。在部分肾切除术后手术切缘阴性的患者中,放射学检测到类似血管平滑肌脂肪瘤的病变被定义为“术后脂肪瘤”。这个包含脂肪组织的肿块在至少1年内既没有血管化和增强,也没有大小增加。我们认为这些病变必须作为良性病变,不需要额外的治疗。
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引用次数: 0
期刊
Journal of Kidney Cancer and VHL
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