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本文报道1例女性患者,35岁,因间断性左侧腰部疼痛1周住院。经腹部超声及CT发现左肾肿物,行左肾根治性切除术,病理示肾母细胞瘤。术后行放线菌素D+长春新碱+阿霉素三联化疗4个周期,复查未见新的病灶。成人肾母细胞瘤(adult Wilms’tumor)是一种非常罕见的恶性肾实体瘤,仅占肾母细胞瘤患者中的1%~2%。由于患者临床症状并不典型,成人Wilms瘤主要依靠术后病理证实。成人Wilms瘤影像学诊断方面仅能显示肾肿物的存在,无明显特异性,术前诊断比较困难。术后临床分期和病理诊断为成人患者的进一步治疗以及预后提供了依据。回顾分析北京大学第一医院泌尿外科自1950年至2007年共收治的6例成人肾母细胞瘤病例以及国内外相关的文献报道可以看出,依据儿童Wilms瘤治疗指南对成人患者行术后辅助治疗可以显著提高生存率。
This article reports a female patient, aged 35, hospitalized for intermittent left lumbar pain for 1 week. Transabdominal ultrasound and CT found that the left kidney tumor, left radical nephrectomy, pathology showed nephroblastoma. Postoperative line actinomycin D + vincristine + doxorubicin triple chemotherapy 4 cycles, no new lesions were reviewed. Adult Wilms’tumor is a very rare malignant renal solid tumor that accounts for only 1% to 2% of patients with nephroblastoma. Due to the clinical symptoms of patients is not typical, adult Wilms tumor mainly depends on pathology confirmed. Imaging diagnosis of adult Wilms tumor can only show the existence of renal tumor, no obvious specificity, preoperative diagnosis is more difficult. Postoperative clinical staging and pathological diagnosis of adult patients for further treatment and prognosis provide the basis. Retrospective analysis of the First Hospital of Peking University Urology from 1950 to 2007, a total of 6 cases of adult Wilms tumor and related literature reports at home and abroad can be seen, based on the treatment of pediatric Wilms tumor in patients with postoperative adjuvant Treatment can significantly improve survival.