個案報告及文獻回顧:後腹腔血管瘤酷似腎細胞癌
陳致豪1、李高漢1、劉建良1、黃冠華2
1奇美醫學中心 外科部 泌尿科
2奇美醫學中心 外科部 泌尿腫瘤科
Retroperitoneal hemangioma mimicking renal cell carcinoma: A case report & review of literature
Zhi-Hao Chen1, Kau-Han Lee1, Chien-Liang Liu1, Steven Kuan-Hua Huang2
1Divisions of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan
2Divisions of Urological Oncology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan
Introduction: Retroperitoneal capillary hemangioma is very rare, only accounts for 1-3% of retroperitoneal tumors. Retroperitoneal capillary hemangioma is mostly found incidentally. However, it can be fatal if tumor ruptured. We described a retroperitoneal capillary hemangioma, which was found as suspected renal cell carcinoma, during diagnosis of gallstone pancreatitis. Retroperitoneoscopic excision of the tumor was performed smoothly and pathology showed a rare capillary retroperitoneal hemangioma.
Case report: A 42 years old man with history of gallbladder stones admitted to GI ward due to common bile duct stone with acute interstitial edematous pancreatitis. Abdominal CT incidentally found an 1.3cm exophytic enhanced nodule at upper pole of right kidney, suspect of renal cell carcinoma. Endoscopic retrograde cholangiopancreatogram was performed and common bile duct stone was removed. He was then discharged and referred to genitourinary department for management of right renal tumor. Retroperitoneoscopic partial nephrectomy was arranged. During the operation, a 1.5cm tumor was found within perirenal fat and did not attach to the right kidney, confirmed by the intracorporeal ultrasound. Therefore, excision of retroperitoneal tumor was done smoothly via laparoscopy. Pathology report showed right retroperitoneal capillary hemangioma embedded in adipose tissue with dilated blood vessels filled with red blood cells. No malignancy was observed. The patient had stable condition after the operation and discharged smoothly on POD 3.
Conclusion: Retroperitoneal capillary hemangioma is rare and could mimic RCC. There is no radiographic criteria to establish the diagnosis yet. Operative resection is suggested for these patient, which could have correct diagnosis and reduce subsequent risk of hemorrhage.