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目的提高对马蹄肾并肾母细胞瘤的认识,减少误诊误治。方法对我院收治经手术病理检查明确诊断的马蹄肾并肾母细胞瘤1例的临床资料进行回顾性分析。结果本例因发现腹部肿物6 d入院,无明显消化系和泌尿系症状,生命体征正常,消瘦明显,CT检查示左上腹腹膜后巨大肿物,未见左肾。按腹膜后巨大肿瘤行剖腹探查术,术中见左侧腹膜后肿物,双肾于下极融合,呈马蹄状,肿瘤未超过马蹄状肾狭部。游离并切断肿物及马蹄肾狭部,缝扎右肾切缘,切断左侧输尿管,完整切除左肾肿物。术后病理检查报告:肾母细胞瘤伴片状坏死。诊断:马蹄肾并肾母细胞瘤。予放线菌素D加长春新碱化疗,病情好转出院。结论马蹄肾并肾母细胞瘤临床罕见,临床医师应提高认识,以减少误诊误治。
Objective To improve the understanding of horseshide kidney and nephroblastoma and reduce the misdiagnosis and mistreatment. Methods The clinical data of 1 case of horseshide kidney and nephroblastoma diagnosed by operation and pathology in our hospital were retrospectively analyzed. The results of this case found abdominal mass 6 d admission, no obvious symptoms of digestive and urinary tract, vital signs, weight loss significantly, CT examination showed a large retroperitoneal tumor of the left upper quadrant, no left kidney. According to the retroperitoneal giant tumor laparotomy, intraoperative see the left retroperitoneal tumor, kidney fusion in the lower pole, was horseshoe-shaped, the tumor did not exceed the horseshoe-shaped renal stenosis. Free and cut off the tumor and horseshoe kidney narrow, suture the right kidney cut edge, cut off the left ureter, complete removal of the left kidney tumor. Postoperative pathology report: Wilms tumor with flake necrosis. Diagnosis: horseshoe kidney and nephroblastoma. To actinomycin D vincristine chemotherapy, condition improved discharged. Conclusion Horseshoe kidneys and nephroblastoma are rare and clinicians should raise their awareness to reduce misdiagnosis and mistreatment.