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肾血管平滑肌脂肪瘤较少见,临床上易误诊。本文报告1例右肾血管平滑肌脂肪瘤:男,28岁。腰部酸胀,多尿、遗精,性欲减低伴头昏、乏力,注意力不集中。检查,面部及全身皮肤褐黑色,以颜面、乳头,腋窝,阴部明显。尿常规正常,24小时尿游离皮质醇10～175μg,B超检查左肾下极见17×17mm强光团;右肾下极见41×41mm强光团,边缘不规则,光团内光点分布较均匀。静脉尿路造影见右肾下极一不规则密度增高组织影,下盏受压变形向上推移;左肾下盏和输尿管的间距较宽,输尿管起始部稍向内上弯曲。初诊:双肾下极肿瘤?手术所见,右肾下极增大,表面呈凸状,术中冰冻切片,疑肾恶性肿瘤,行右肾切除术。术后病理诊断肾血管平滑肌脂肪瘤。经肾上腺皮质激素治疗,症状改善,全身皮肤色素斑消退。讨论本瘤是良性间叶瘤,有人认为是错构瘤。肿瘤常为圆形或卵圆形,及不规则形。小者直径数毫米,大者可达20×10×8cm。与正常肾组织间有
Renal vascular smooth muscle lipoma is rare, clinically misdiagnosed. This article reports a case of right renal angiomyolipoma: male, 28 years old. Sore waist, polyuria, nocturnal emission, decreased libido with dizziness, fatigue, inattention. Check, facial and body skin brown black, with the face, nipple, armpit, pudendal obvious. Urine routine normal 24 hours urinary free cortisol 10 ~ 175μg, B ultrasound examination of the left kidney under the extreme 17 × 17mm light group; the right lower kidney 41 × 41mm extreme light group, the edge of irregular light spot Distribution more evenly. Intravenous urography showed abnormalities in the right lower kidney anomalous tissue density increased, the lower light pressure deformation up; left lower extremity and the ureter wide spacing, the ureter starting slightly curved inward. Newly diagnosed: under the kidney two neoplasms? Surgical findings, the right lower extremity increased, the surface was convex, intraoperative frozen section, suspected renal cancer, right nephrectomy. Postoperative pathological diagnosis of renal vascular smooth muscle lipoma. The adrenal cortex hormones, symptoms, systemic skin pigmentation subsided. Discussion of the tumor is benign mesenchyme, some people think that hamartoma. Tumors are often round or oval, and irregular shape. Small diameter of several millimeters, the largest up to 20 × 10 × 8cm. Between the normal kidney tissue