腎臟類上皮血管肌肉脂肪瘤之臨床病理分析
-單一機構之連續切除之二十三例病例
蔡翰宇1、李昆翰2、吳桂芳3、高毓婷2、莊正鏗1、2
林口長庚醫院 外科部 泌尿科1；長庚大學 醫學院2；林口長庚醫院 病理科3
Clinicopathologic analysis of epithelioid renal angiomyolipoma: a single institute experience of consecutively excised 23 cases
Han-Yu Tsai1, Kun-Han Lee2, Kwai-Fong Ng3, Yu-Ting Kao2, Cheng-Keng Chuang1,4
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan1
Chang Gung University, Chang Gung Memorial Hospital, Taoyuan, Taiwan2
Division of Pathology, Chang Gung Memorial Hospital, Taoyuan, Taiwan3
School of Medicine, Chang Gung University, Taoyuan, Taiwan4
Purpose:
To analyze the clinicopathological feature of renal epithelioid angiomyolipoma (eAML) and provide treatment suggestions.
Materials and Methods:
We analyzed 23 eAML cases found in Chang Gung Memorial Hospital within 2001 to 2016.
Results:
We’ve identified 23 eAML in 570 AML cases (4%). We divide 23 eAML cases into invasive (cases with distant metastasis or vascular invasion, n=5) and non-invasive (n=18) groups. The invasive group shows more severe nuclear atypia and higher rates in tumor necrosis. There are statistically no significant differences as for patient’s age, tumor size and mitotic count between two groups.
Conclusion:
Epithelioid angiomyolipoma is a potentially malignant neoplasm. Five of our 23 cases (=21%) showed invasive behavior. We recommend treating eAML using guidelines for treating renal cell carcinoma, including staging, surgical treatment options and further follow up interval. The diagnosis of eAML pre-operatively by imaging remains a great challenge. We hope that further quantitative CT evaluation is able to differentiate eAML from other kidney tumors pre-operatively.