泌尿男生殖系肿瘤课件.pptVIP

泌尿、男生殖系肿瘤Genitourinary tumor 中南大学湘雅医院泌尿外科 高宁 概 述 泌尿系肿瘤在全身各部位肿瘤中，并不占最重要的地位，但在泌尿系统外科疾病中是常见疾病之一。 The most common genitourinary neoplasms arise in the bladder, kidney, prostate. Testicular cancer is not common. 国外，尤其在欧美国家中，前列腺肿瘤属于最常见的泌尿系肿瘤。 前列腺肿瘤(Prostate tumor)在中国比较少见，近年来有上升趋势。 过去我国常见的生殖系肿瘤中阴(Penis cancer)茎癌的发病率巳有明显下降。 Renal tumors Benign tumors Cystic renal Simple cyst Polycystic kidney Renal hamartoma Malignant renal tumors Primary tumor Renal cell carcinoma Renal adenocarcinoma Nephroblastoma (Wilms tumor) Sarcoma Carcinoma of the Renal Pelvis and Ureter. Secondary tumor Incidence Adenocarcinoma of the kidney accounts for almost 85% of all renal neoplasms。 Carcinoma of the Renal Pelvis and Ureter accounts for almost 7%-8% of all renal neoplasms。 Nephroblastoma accounts for almost 5%-6% of all renal neoplasms 。 但在成人全身恶性肿瘤中，肾肿瘤仅占1%左右。 而儿童恶性肿瘤肿，肾母细胞瘤可达20%，在小儿腹部肿块性疾病中是最常见的疾病。 肾脏肿瘤以恶性肿瘤多见，任何肾脏的肿瘤在未获得病理学证实以前，应高度怀疑为恶性肿瘤。 Renal cell carcinoma 肾癌亦称为肾细胞癌，在肾肿瘤中占主要地位，肾癌约占肾脏肿瘤的四分之三，是最常见的肾实质恶性肿瘤。 随着诊断水平的提高以及年龄结构老年化的改变，临床上肾癌发病率有明显增高的趋势。 临床上许多无任何证状的肾肿瘤，在体检及Ｂ超检查中被偶然发现，肾脏的“偶发癌”有所增加。 Etiology The etiology of renal cell carcinoma is unknown, Several interesting associations have been noted. Estrogens diet. High consumption of fats, oils，milk, and sugar. Renal failure Von Hippel-Lindau disease Toxic agents Pathology Renal carcinoma occur with equal frequency in either kidney and are randomly distributed in the upper and lower poles. RCCs originate in the cortex and tend to grow out into perinephric tissue. 有1-2%的病例可能双肾同时或先后出现肾癌。 The tumor average 7-8cm in diameter but can grow to fill the entire retroperitoneum. RCCs do not have true capsules but may have a pseudocapsule of compressed renal parenchyma, fibrous tissue, and inflammatory cell. Larger tumor can exhibit hemorrhage, necrosis with secondary cystic areas , calcification. RCCs are vascular tumors that tend to spread either by direct invasion through the renal capsule into perinephric fat and adjacent visceral structures