Primary Renal Angiosarcoma: A Case Report

原發性腎臟血管肉瘤：病例報告及文獻回顧

阮春榮(Chun-Jung Juan) ； 吳清俊(Ching-Jiunn Wu) ； 薛俊仁(Chun-Jen Hsueh) ； 蕭海松(Hai-Sung Hsiao) ； 劉昌憲(Chang-Hsien Liou) ； 韓鴻志(Horng-Jyh Harn) ； 范洪春(Hueng-Chuen Fan) ； 于大雄(Dah-Shyong Yu)

《中華放射線醫學雜誌》 25卷2期 (2000/04) Pp. 87-90

摘要

原發性腎臟血管肉瘤是一種高度惡性且預後極差的血管腫瘤。我們報告一位罹患原發性腎臟血管肉瘤之八十一歲女性。臨床上病患僅表現出無痛性明顯的血尿。此腫瘤卻在電腦斷層上呈現不規則的邊緣及壞死，與典型的腎臟細胞瘤不相同。血管攝影檢顯示有少許的腫瘤新生血管及腫瘤濃染，排除了腎臟發炎的可能性。最後之診斷仍需依賴病理切片。除了腎臟切除手術外，病患並接受放射治療，然而，六個月後之音波及電腦斷層追蹤發現肝臟有轉移之病灶。經過保守性之化學治療之後，病患仍因肝衰竭引發肝腦病變而於術後9個月死亡。我們回顧文獻發現本病例是目前所有報告中年齡最大的一位。

關鍵字

腎臟腫瘤，電腦斷層攝影 ； 腎臟腫瘤，血管攝影 ； 血管肉瘤

並列摘要

Primary renal angiosarcoma is a high-grade malignant vascular tumor with a dismal prognosis. An 81-year-old woman with a primary angiosarcoma of the left kidney presented with a 3-month history of painless gross hematuria. On contrast-enhanced CT scans, the tumor was more infiltrative than that typically seen in renal cell carcinoma. Angiography, which was performed in order to differentiate a malignant tumor from an inflammatory mass, revealed a small number of tumor vessels and tumor stain. In addition to a radical nephrectomy, the patient received radiotherapy on the left renal fossa with a total of 4.35 Gy. Unfortunately, a follow-up sonogram revealed diffuse liver metastasis 6 months after surgery. Palliative chemotherapy including Ifosphamide and Mesna was given. However, hepatic failure complicate with hepatoencephalopathy developed during the 3rd course of chemotherapy. The patient died 9 months after nephrectomy. To our knowledge, this is the oldest reported patient with primary renal angiosarcoma.

並列關鍵字

Kidney neoplasms, CT ； Kidney neoplasms, Angiography ； Angiosarcoma