一名青少年的 Bosniak III 囊肿掩盖了管状囊性肾细胞癌:选择性动脉夹闭和机器人去核术的治疗方法

Surgeries Pub Date : 2024-05-16 DOI:10.3390/surgeries5020034
Marcello Della Corte, Elisa Cerchia, Marco Allasia, Alessandro Marquis, Alessandra Linari, Martina Mandaletti, Elena Ruggiero, Andrea Sterrantino, Paola Quarello, Massimo Catti, Franca Fagioli, Paolo Gontero, Simona Gerocarni Nappo
{"title":"一名青少年的 Bosniak III 囊肿掩盖了管状囊性肾细胞癌:选择性动脉夹闭和机器人去核术的治疗方法","authors":"Marcello Della Corte, Elisa Cerchia, Marco Allasia, Alessandro Marquis, Alessandra Linari, Martina Mandaletti, Elena Ruggiero, Andrea Sterrantino, Paola Quarello, Massimo Catti, Franca Fagioli, Paolo Gontero, Simona Gerocarni Nappo","doi":"10.3390/surgeries5020034","DOIUrl":null,"url":null,"abstract":"The Bosniak classification of renal cysts aims to provide a probabilistic risk assessment indicating the likelihood of malignancy from imaging findings. Originally designed to classify adult renal cysts based on computed tomography findings, the Bosniak classification has been extended to pediatric patients, with some adjustments made with the aim of accommodating magnetic resonance imaging (MRI) and ultrasonography (US). Bosniak IV lesions are rare in adolescents, indicating localized renal cell carcinoma and requiring surgical intervention. In contrast, Bosniak III lesions can be treated conservatively, although there is a lack of specific guidelines on their management. We present a case of a 14-year-old boy with a Bosniak III lesion, which was incidentally detected during the US evaluation of a left varicocele. After a 12-month follow-up, MRI revealed progression to a Bosniak IV cyst. Robot-assisted tumor enucleation was performed with selective artery clamping when the patient was 15. Histopathology showed tubulocystic renal cell carcinoma without adverse features. Immunocytochemistry supported a favorable prognosis of this rare tumor (<1% of renal tumor), thus obviating the need for adjuvant treatment. At the 18-month follow-up, no recurrence or distant metastasis were observed. This case highlights the importance of an aggressive treatment in persistent Bosniak III and Bosniak IV renal cysts in children and adolescents and the necessity to offer a nephron-sparing surgery.","PeriodicalId":506240,"journal":{"name":"Surgeries","volume":"34 3","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Bosniak III Cyst Unmasking Tubulocystic Renal Cell Carcinoma in an Adolescent: Management with Selective Arterial Clamping and Robotic Enucleation\",\"authors\":\"Marcello Della Corte, Elisa Cerchia, Marco Allasia, Alessandro Marquis, Alessandra Linari, Martina Mandaletti, Elena Ruggiero, Andrea Sterrantino, Paola Quarello, Massimo Catti, Franca Fagioli, Paolo Gontero, Simona Gerocarni Nappo\",\"doi\":\"10.3390/surgeries5020034\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The Bosniak classification of renal cysts aims to provide a probabilistic risk assessment indicating the likelihood of malignancy from imaging findings. Originally designed to classify adult renal cysts based on computed tomography findings, the Bosniak classification has been extended to pediatric patients, with some adjustments made with the aim of accommodating magnetic resonance imaging (MRI) and ultrasonography (US). Bosniak IV lesions are rare in adolescents, indicating localized renal cell carcinoma and requiring surgical intervention. In contrast, Bosniak III lesions can be treated conservatively, although there is a lack of specific guidelines on their management. We present a case of a 14-year-old boy with a Bosniak III lesion, which was incidentally detected during the US evaluation of a left varicocele. After a 12-month follow-up, MRI revealed progression to a Bosniak IV cyst. Robot-assisted tumor enucleation was performed with selective artery clamping when the patient was 15. Histopathology showed tubulocystic renal cell carcinoma without adverse features. Immunocytochemistry supported a favorable prognosis of this rare tumor (<1% of renal tumor), thus obviating the need for adjuvant treatment. At the 18-month follow-up, no recurrence or distant metastasis were observed. This case highlights the importance of an aggressive treatment in persistent Bosniak III and Bosniak IV renal cysts in children and adolescents and the necessity to offer a nephron-sparing surgery.\",\"PeriodicalId\":506240,\"journal\":{\"name\":\"Surgeries\",\"volume\":\"34 3\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgeries\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3390/surgeries5020034\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgeries","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/surgeries5020034","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

Bosniak肾囊肿分类法旨在提供一种概率风险评估,根据成像结果显示恶性肿瘤的可能性。Bosniak分类法最初是根据计算机断层扫描结果对成人肾囊肿进行分类,现已扩展到儿科患者,并根据磁共振成像(MRI)和超声波成像(US)进行了一些调整。波 Bosniak IV 型病变在青少年中很少见,表明是局部肾细胞癌,需要手术治疗。与此相反,Bosniak III 型病变可采取保守治疗,但目前还缺乏具体的治疗指南。我们介绍了一例患有 Bosniak III 病变的 14 岁男孩,该病变是在对左侧精索静脉曲张进行 US 评估时偶然发现的。经过 12 个月的随访,核磁共振成像显示该病变发展为波什尼亚克 IV 型囊肿。患者 15 岁时,在机器人辅助下进行了肿瘤切除术,并选择性夹闭动脉。组织病理学显示为肾小管囊性细胞癌,无不良特征。免疫细胞化学证实这种罕见肿瘤(在肾肿瘤中占比小于1%)预后良好,因此无需进行辅助治疗。在 18 个月的随访中,未发现复发或远处转移。该病例强调了积极治疗儿童和青少年顽固性波什尼亚克 III 型和波什尼亚克 IV 型肾囊肿的重要性,以及进行保肾手术的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
A Bosniak III Cyst Unmasking Tubulocystic Renal Cell Carcinoma in an Adolescent: Management with Selective Arterial Clamping and Robotic Enucleation
The Bosniak classification of renal cysts aims to provide a probabilistic risk assessment indicating the likelihood of malignancy from imaging findings. Originally designed to classify adult renal cysts based on computed tomography findings, the Bosniak classification has been extended to pediatric patients, with some adjustments made with the aim of accommodating magnetic resonance imaging (MRI) and ultrasonography (US). Bosniak IV lesions are rare in adolescents, indicating localized renal cell carcinoma and requiring surgical intervention. In contrast, Bosniak III lesions can be treated conservatively, although there is a lack of specific guidelines on their management. We present a case of a 14-year-old boy with a Bosniak III lesion, which was incidentally detected during the US evaluation of a left varicocele. After a 12-month follow-up, MRI revealed progression to a Bosniak IV cyst. Robot-assisted tumor enucleation was performed with selective artery clamping when the patient was 15. Histopathology showed tubulocystic renal cell carcinoma without adverse features. Immunocytochemistry supported a favorable prognosis of this rare tumor (<1% of renal tumor), thus obviating the need for adjuvant treatment. At the 18-month follow-up, no recurrence or distant metastasis were observed. This case highlights the importance of an aggressive treatment in persistent Bosniak III and Bosniak IV renal cysts in children and adolescents and the necessity to offer a nephron-sparing surgery.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Severe Attrition and Poor Satisfaction in Patients Undergoing Telerehabilitation vs. Standard In-Person Rehabilitation after Arthroscopic Rotator Cuff Repairs and Anterior Cruciate Ligament Reconstructions Pediatric Intracranial Aneurysms: Experience from a Singapore Children’s Hospital Evaluating Anticoagulant and Antiplatelet Therapies in Rhesus and Cynomolgus Macaques for Predictive Modeling in Humans A Bosniak III Cyst Unmasking Tubulocystic Renal Cell Carcinoma in an Adolescent: Management with Selective Arterial Clamping and Robotic Enucleation Osteoimmunology: An Overview of the Interplay of the Immune System and the Bone Tissue in Fracture Healing
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1