Cerrahi olarak tedavi edilen böbrek kitlelerinin histopatolojisi: 178 vakanın analizi

Abstract

Amaç: Malignite şüphesiyle cerrahi olarak tedavi edilen böbrek kitlelerinin patolojik değerlendirmesini yaparak serimizdeki benign lezyonların sıklığını ve uygulanan tedavi yöntemlerini tespit etmek.Gereç ve Yöntemler : Şubat 2005 ile Aralık 2010 arasında malignite şüphesi nedeniyle ameliyat edilen 188 böbrek kitleli hastanın 120 erkek,68 kadın hasta kayıtları retrospektif olarak incelendi.Bulgular: Toplam 188 hastanın 178’inin kayıt bilgileri eksiksizdi. Bu hastalardan 142’sine radikal nefrektomi % 79 , 28’ine nefron koruyucu cerrahi %15 , 4’üne sadece böbrek biyopsisi %3 ve 4’üne de nefroüreterektomi %3 yapıldı. 178 tümörün 66’sının 37% tanısı insidental olarak konuldu. İnsidental saptanan kitlelerin 43’ünün %66 boyutu 7 cm’den küçüktü. Patolojik değerlendirmede 156 %88 hastada malignite saptanırken, 22 %12 hastada benign patolojiler bulundu. Benign kitleler sırasıyla onkositom n=11 , anjiomiyolipom n=6 , kistik nefroma n=2 , ksantogranülomatöz pyelonefrit n=2 ve metanefrik adenom n=1 idi. 7’cm den küçük 91 böbrek kitlesinin 22’sinde %24 benign patoloji saptandı. Benign kitlelerin hiçbiri 7 cm’den büyük değildi.Sonuç: Preoperatif malign olarak şüphe edilen kitleler, radyolojik görüntüleme yöntemlerindeki teknolojik gelişmelere rağmen, benign çıkabilmektedir. İnsidental olarak saptanan ve boyutu 7 cm’den küçük olan böbrek kitlelerinde nefron koruyucu cerrahi ön planda tutulmalıdır

Keywords

• Benign patoloji,böbrek kitlesi,nefron koruyucu cerrahi

Histopathology of surgically managed renal tumors: analysis of 178 cases

Abstract

Objective: To review the pathologic findings of a contemporary series of surgically treated renal tumors suspicious for malignancy to assess the frequency of benign disease and treatment modality.Materials and Methods: The records of 188 patients 120 male, 68 female underwent surgery for suspicious renal mass for malignancy between February 2005 and December 2010 were reviewed retrospectively.Results: Of 188 cases, records of a total of 178 cases were available for analysis. 142 patients underwent radical nephrectomy 79% , 28 nephron sparing surgery 15% , 4 renal biopsy 3% and 4 nephroureterectomy 3% . Of 178 tumors, 66 37% were discovered incidentally. Forty three 66% of incidentally diagnosed renal masses size were less than 7 cm. The pathologic evaluation demonstrated malignancy in 156 88% and benign disease in 22 12% .Benign masses were oncocytoma n=11 , angiomyolipoma n=6 , cystic nephroma n=2 , xanthogranulomatous pyelonephritis n=2 and metanephric adenoma n=1 . Of 91 renal masses with size of less than 7 cm, 22 24% had benign pathology and none of benign masses were bigger than 7 cm.Conclusion: Inspite of great technological development in the radiological imaging modalities, benign lesions may still be detected pathologically in the patients with preoperative diagnosis of renal cancer. Nephron sparing surgery should be kept in mind for the renal masses less than 7 cm, if possible

Keywords

• Benign pathology,renal mass,nephron sparing surgery

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