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患儿男性,7岁。主因无痛性镜下血尿半年,无食欲不振、恶心、呕吐等。全身情况好,静脉尿路造影示:左肾上盖受压呈弧形。B超及CT检查显示:左肾上极囊肿。术前诊断:左肾上极囊肿。术中探查:左肾上极皮质变薄,触之呈囊性感,约3×3cm大小,切开囊被膜后,吸出胶胨状粘稠物2ml,同时吸出少许乳头状组织。腔内光滑,向下与肾盂相通,未触及肿物,行左肾上极部分切除术。病理报告:左肾上极皮质乳头状囊腺病,建议临床严密观察。术后镜下血尿一度消失。术后半年再度出现血尿,偶有无痛肉眼皿尿。B超复查:左肾上部囊肿,约3×3cm大小。行根治性左肾切除术。大体标本:左肾上盏呈囊性扩张,约3×3cm,其内有带蒂之肿物,表面有出血及坏死。病理报告:左肾腺癌。
Children with children, 7 years old. Mainly because of painless microscopic hematuria six months, no loss of appetite, nausea, vomiting and so on. The general condition is good, intravenous urography showed: the left renal capsule pressure was curved. B ultrasound and CT examination showed: the left kidney on the pole cyst. Preoperative diagnosis: the left renal pole cyst. Surgical exploration: the left renal parenchyma thinning, touching a cystic sexy, about 3 × 3cm size, cut capsule capsule, aspirate thick viscous material 2ml, while sucking out a little papillary tissue. Intraluminal smooth, down with the renal pelvis, did not touch the tumor, the line of the left upper pole partial excision. Pathology report: left renal cortex papillary cystosis, it is recommended clinical close observation. Postoperative microscopic hematuria disappeared. Six months after the re-occurrence of hematuria, occasional painful pen and urine dish. B-ultrasound: left upper kidney cyst, about 3 × 3cm size. Radical left nephrectomy. Gross specimen: The upper left renal capsule was cystic dilatation, about 3 × 3cm, which has a pedunculated mass, the surface bleeding and necrosis. Pathology report: Left renal adenocarcinoma.