RENAL KİTLE NEDENİYLE AMELİYAT EDİLEN HASTALARIMIZIN PATOLOJİK VERİLERİNİN DEĞERLENDİRİLMESİ

Öz

Cerrahi olarak tedavi ettiğimiz renal kitlelerin patolojik özelliklerini ve tedavi seçimini inceledik. Çalışmada 137 hasta verileri değerlendirildi. Hastalarımızın yaş ortalaması 56 31-91 idi. Kitle boyutu ortalama 6,4 cm 2,3-16 olarak saptandı. Bu hastalardan 16’sına %11,6 tümör boyutunun küçük olması ve yerleşimin uygun olması nedeniyle parsiyel nefrektomi uygulandı. Bu hastalardan 4 %25 tanesine laparoskopik parsiyel nefrektomi uygulandı. 121 hastaya radikal nefrektomi uygulandı. Bu hastalardan 33 %27,2 tanesine laparoskopik nefrektomi uygulandı. Radikal nefrektomi yapılan hastaların patolojik tanıları, berrak hücreli karsinom 74 %54 , papiller tip 18 %13 , kromofob hücreli tip 13 %10 , eosinofilik tip 6 %5 , transizyonel hücreli karsinom TCC 7 %5 , onkositom 11 %7 , 3 hastada anjiomyolipom, birer ise diffüz B hücreli lenfoma, epidermoid karsinom metastazı idi. Parsiyel nefrektomi uyguladığımız hastalardan 2’ sinin %12 patolojisi onkositom ve anjiomyolipom olarak geldi. Diger 14 %88 hasta ise berrak hücreli karsinom idi. Tüm hastalar değerlendirildiğinde; 16 %11 hastada benign patolojiler saptandı.

Anahtar Kelimeler

• Renal kitle,cerrahi tedavi,benign,histopatoloji

EVALUATION OF THE PATOLOGICAL RESULTS OF PATIENTS OPERATED FOR RENAL MASS

Abstract

To evaluate the treatment options and pathological findings of patients with renal massess in our clinic. Totally 137 patients who undergone surgical treatment for renal masses were evaluated retrospectively. The mean age was 56 range: 31-91 years old and the mean size of masses was 6,4 cm range: 2,3-16 . Partial nephrectomy was performed to 16 11,6% patients and 25% of them treated with laparoscopically. Open radical nephrectomy and laparoscopic radical nephrectomy were performed to 88 64,2% and 33 24,1% patients respectively.The pathological results of radical nephrectomies were clear cell carcinoma in 74 54% patients, renal papillary carcinoma in 18 13% patients, chromophobe cell carcinoma in 13 10% patients, eosinophilic cell carcinoma in 6 5% patients, transitional cell carcinoma in 7 5% patients, oncocytoma in 11 7% patients, angiomyolipoma in 3 patients; and diffuse B-cell lymphomasquamous cell carcinoma metastases in 1 patient respectively. The partial nephrectomy results were; clear cell carcinoma in 14 88% patients, angiomyolipoma in 1 patient and oncocytoma in 1 patient. The pathological findings revealed that 16 11% patients were operated for benign pathologies. Radical nephrectomy is the gold standard treatment of renal tumors. Laparoscopic surgery should be preferred in suitable cases. We should kept in mind that all renal tumor pathologies are not malign thus partial nephrectomy could be a good option for protect kidney in suitable patients.

Keywords

• Renal mass,surgical treatment,histopathology

Kaynakça

1. ) Tan HJ, Jacobs BL, Hafez KS, Montgomery JS, Weizer AZ, Wood DP et al. Understanding the role of percutaneous biopsy in yhe management of patients with a small renal mass. Urology 2012; 79(2): 372- 7.
2. ) Stewart GD, Ang WJ, Laird A, Tolley DA, Riddick AC, McNeill SA. The operative safety and oncological outcomes of laparoscopic nephrectomy for T3 renal cancer. BJU Int. 2012 Sep;110(6):884-90.
3. ) Klein MJ, Valensi QJ. Proximal tubular adenomas of kidney with so-called oncocytic features. A clinicopathologic study of 13 cases of a rarely reported neoplasm. Cancer. 1976;38:906–14.
4. ) Ambos MA, Bosniak MA, Valensi QJ, Madayag, Lefleur RS. Kartal Eğitim ve Araştırma Hastanesi Tıp Dergisi 102 MA, Lefleur RS. Angiographic patterns in renal oncocytomas. Radiology 1978;129(3):615-22.
5. ) Nelson, C. P., Sanda, M. G.: Contemporary Diagnosis and Management of Renal angiomyolipoma. The Journal of Urology, 2002; 168(4): 1315-25.
6. ) Tuna B. Renal hücreli kanserlerin patolojisi ve moleküler biyoloji. Üroonkoloji Bülteni 2013; 3:201 -4.
7. ) Rha SE, Byun JY, Jung SE, Oh SN, Choi YJ, Lee A et al. The renal sinus: pathologic spectrum and multimodality imaging approach. Radiographics. 2004;24(Suppl 1): S117 –S131.
8. ) Karadeniz C, Oguz A, Ataoglu O, Citak C, Buyan N, Pinarli G, Primary renal lymphoma and xanthogranulomatous pyelonephritis in childhood. J Nephrol 2002;15(5): 597.

9. ) Kılıç N, Balkan E, Sevinir B, Filiz G, Doğruyol D. Primer böbrek tümörü gibi beliren b-hücreli böbrek lenfoması. Çocuk Cerrahisi Dergisi 2005;19:136-8.
10. ) Moran E, Rogel R, Soto A. Usefulness of new schemes to group Fuhrman grades in clinical practice for clear cell renal tumour. Actas Urol Esp. 2012;36(6):352-8.