| Objective:In order to improve the ability of diagnosis,we conducted a retrospective analysison the cystic renal cell carcinoma (CRCC) to detect its clinical features and treatment possibilities.Methods:18 cases of CRCC from 513 cases of renal cancers were selected from patients admitted in the first Affiliated Hospital of Guangxi Medical University from January 2004 to December 2014. All the clinical date were collected and analyzed so as to summarize the features in diagnosis and prognosis of CRCC.Results:(1)The number of CRCC accounted for 3.5% of the renal cell carcinoma (RCC) cases in the same period.Among the 18 cases,14 were male (77.8%) and 4 were female (22.2%) with male-to-female ratio of 3.5:1.(2)The mean age of the 18 patients was 49.4 years old [youngest:31 years, oldest:70 years; 30-40:8 cases(44.4%),41-50:3 cases(16.7%),51-60:1 cases (5.6%), 61-70:6 cases (33.3%)).(3)A11 patients were not presenting all three typical symptoms of RCC:9 cases (50%) for the physical examination,5 cases (27.8%) for the low back pain,2 cases (11.1%) for the discovery of abdominal mass and hematuria,2 cases (11.1%) for the other disease examination.There were no evidence for tumor invasion or metastasis among all the patients after preoperative routine examination such as chest X-ray, ultrasound, urological CT scan,blood routine, renal function examination among others.Only one case was incorrectly diagnosed as renal cyst before operation. (4)8 cases were treated with laparoscopic radical nephrectomy,4 cases applied laparoscopic renal space-occupying enucleation,4 used the open radical nephrectomy, the surgical method of 1 patient was changed from open renal space-occupying enucleation to open radical nephrectomy after frozen section pathology proving as CRCC, the last one was diagnosed as renal cyst and underwent laparoscopic renal cyst un-roofing decompression whose postoperative pathology was CRCC, then hospitalizing for radical nephrectomy again. (5)The postoperative pathological showed that 14 cases (77.8%) were multilocular cystic renal cell carcinoma, and 4 cases (22.2%) were single cystic renal cell carcinoma. The tumor diameter was 1.8～9.1cm(average 4.6 cm). The tumor in 8 cases(44.4%) was located in the upper pole.4 cases(22.2%) were in the middle pole. And 6 (33.3% ) were in the lower pole.16 cases (88.9%) were pT0NOM0,1 case(5.6%) was pT2N0M0,1 cases (5.6%)was pT3bN0M0. All cases were without complications.(6)15 of the 18 cases were followed up and alive without complications,3 cases were lost follow-up. The follow-up time ranged from 3 to 88 months (average 25.6 months).13 cases did the medical examination such as chest X-ray, ultrasound, urological CT or MRI scan. There were no sign that the tumor were recurrence or metastasis.Conclusion:Cystic renal cell carcinoma is a rare type of renal cell carcinoma. When the CT and sonography showed the irregular thickening of the cystic wall and septun,muddy cystic content, enhancement of the solid component, and color flow in solid component or septum, we should consider the possibility of CRCC. The patients have an excellent prognosis. |
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