| Objective:Our aim was to investigate the diagnosis and treatment of cystic renal cell carcinoma.Methods:67cases with cystic renal cell carcinoma were treated from Jan2005to Apr2013in First Affiliated Hospital of Zhejiang University, and we retrospectively analyze the clinical manifestations, diagnostic methods, surgical approach, pathological findings and prognosis. Preoperative imaging procedures suggested renal cysts relative masses in67cases, including malignant tumors in59cases. Intraoperative pathological examination was undertaken in59cases and the pathological results showed malignant tumors in56cases, renal cyst in2cases and multi-cell renal cyst in one case. The surgical procedures included radical nephrectomy(n=19), partial nephrectomy(n=12), retroperitoneal laparoscopic radical nephrectomy(n=9), retroperitoneal laparoscopic partial nephrectomy (n=20), first retroperitoneal laparoscopic cyst unroofed then transferred radical nephrectomy(n=6), and retroperitoneal laparoscopic partial nephrectomy at first, then transferred radical nephrectomy (n=1).Results:All67cases were confirmed postoperatively as renal carcinoma, including clear renal cell carcinoma with cystic changes in31cases, multilocular renal cell carcinoma in36cases,and it includes four cases with other concurrent clear renal cell carcinoma.62cases of malignancy were followed up for10-110months(median56months).7cases which were diagnosed benign pre-operation or intra-operation but malignant by pathological examination after-surgery were followed up for61-103months(median82months). The surgical results showed excellent in all62cases with follow-up and there was no evidence of neoplastic recurrence or metastasis. Conclusions:Imaging plays an important role in the early diagnosis of cystic renal cell carcinoma. Intraoperative pathological examination should be performed in suspected cases. Nephron-sparing surgery is preferred to treat the diagnosed patients and usually has a good outcome. |
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