腎嗜酸細胞瘤：病例報告及文獻回顧
鍾卓興、高偉棠
行政院衛生福利部雙和醫院泌尿科
Renal oncocytoma: a rare case and literature review
Chung Cho-Hsing, Kao Wei-Tang
Departmentof Urology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
Purpose:
To report a rare case of renal oncocytoma in a 58-year-old male that accidentally found by computed tomography.
Case presentation:
We describe a 58-year-old male presenting with bubbles in urine for half year. He had no lower urinary tract symptoms but hypertension and diabetes mellitus type 2. Ultrasound showed One homogenic mass (8.14*5.65cm) with calcification (0.91cm) within the low pole of right kidney. Computed tomography showed no intralesional fat, vessels invasion, enlarged lymph nodes and sufficient to differentiate this lesion from renal cancer but a centrally located stellate area of low attenuation at lower pole of right kidney. The size of the mass measured about 8 cm. We then performed the CT guide biopsy. The immunohistopathology of the mass was consistent with renal oncocytoma an there was no nephrotic change.
Conclusion:
Oncocytomas are usually diagnosed incidentally and patients do not have urologic complaints. Several reports have characterised this essentially benign renal histiotype, which represents 5% to 7% of all solid renal masses. Unfortunately, most renal oncocytomas cannot be differentiated from malignant renal cell carcinomas by clinical or radiographic criteria. Central stellate scar and a spoke-wheel pattern of feeding arteries are unreliable diagnostic signs and are of poor predictive value. These tumors are treated operatively with radical or partial nephrectomy or thermal ablation, depending on the clinical circumstances.