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肾血管平滑肌脂肪瘤临床罕见,伴恶变、术后复发尚未见报道。现报告1例如下:患者女,48岁,以右上腹无痛性包块14年,近1个月包块增大并持续性腹痛,于1986年7月31日入院。查体:一般状况尚可。腹软,肝脾不大;右中上腹部扪及手拳大硬性包块,边界清,移动度差,移动性浊音(-)。血常规:白细胞13.4×10~9/L,中性82％,血红蛋白95g/L,血沉21mm/h;尿常规:蛋白(±),WBC 5～10/HP,RBC 0～1/HP。肝功能、血尿素氮、CO_2结合力、血清钾、钠、氯均在正常范围。B超检查:左肾10×5.6×6.6cm;右肾16×8.4×8.0cm,其下极见6×5cm不规则的混合回声区,与肾无明显分界。IVU:左肾正常,右肾未显影。临床诊断:右肾肿瘤。
Renal vascular smooth muscle lipoma is clinically rare, with malignant transformation, postoperative recurrence has not been reported. Now report a case as follows: The patient female, 48 years old, right upper quadrant painless mass 14 years, nearly 1 month mass and sustained abdominal pain, on July 31, 1986 admitted. Physical examination: the general situation is acceptable. Abdomen soft, small spleen and kidney; right middle and upper abdomen palpable hand block big rigid mass, clear boundary, poor mobility, dullness of mobility (-). Blood: white blood cells 13.4 × 10 ~ 9 / L, neutral 82%, hemoglobin 95g / L, erythrocyte sedimentation rate 21mm / h; urine routine: protein (±), WBC 5 ~ 10 / HP, RBC 0 ~ 1 / HP. Liver function, blood urea nitrogen, CO 2 binding, serum potassium, sodium, chlorine were in the normal range. B-ultrasound: the left kidney 10 × 5.6 × 6.6cm; right kidney 16 × 8.4 × 8.0cm, its extremely small 6 × 5cm irregular hybrid echo area, no significant boundary with the kidney. IVU: Left kidney is normal, right kidney is not developed. Clinical diagnosis: right kidney tumor.