一名75岁的男子因高血压和慢性肾功能衰竭在附近的诊所接受随访。由于腹部超声显示左侧肾脏肿瘤,该患者被转诊至我们部门。普通计算机断层扫描(CT)显示左肾上极有50毫米复杂的肾囊肿。磁共振平片显示囊性肿块,有许多间隔。怀疑隔片部分增厚,病变分为BosniakIIF或III.由于病人有肾功能不全,定期对肿瘤病变进行影像学检查,以确定手术时机.第二年,普通CT显示一个直径20毫米的新肾肿瘤位于已知肿瘤的外侧,质量有增加的趋势。引入血液透析后,患者接受了腹腔镜根治性左肾切除术。组织病理学检查显示,位于左肾内侧上极的肿瘤是恶性潜能低的多房性囊性肾肿瘤,位于已知肿瘤外侧的新肿瘤是富马酸水合酶缺乏的肾细胞癌。在同侧肾脏中同时发生富马酸水合酶缺乏的肾细胞癌和恶性潜能低的多房性囊性肾肿瘤极为罕见。我们通过文献回顾来报告我们的病例。
A 75-year-old man was being followed up at a nearby clinic for hypertension and chronic renal failure. The patient was referred to our department as abdominal ultrasound revealed a left renal tumor. Plain computed tomography (CT) showed a 50 mm complex renal cyst in the upper pole of the left kidney. Plain magnetic resonance imaging showed a cystic mass with numerous septa. Partial thickening of the septa was suspected, and the lesion was classified as Bosniak IIF or III. As the patient had renal dysfunction, regular imaging study of the tumor lesion was performed to determine the timing of surgery. In the following year, plain CT revealed a new renal tumor 20 mm in diameter located lateral to the known tumor, with the mass having a tendency to increase. The patient underwent a laparoscopic radical left nephrectomy after the introduction of hemodialysis. Histopathological examination revealed that the tumor located in the medial upper pole of the left kidney was a multilocular cystic renal neoplasm of low malignant potential and that the new tumor located lateral to the known tumor was fumarate hydratase-deficient renal cell carcinoma. Simultaneous occurrence of fumarate hydratase-deficient renal cell carcinoma and multilocular cystic renal neoplasm of low malignant potential in the ipsilateral kidney is extremely rare. We report our case with a
review of the literature.