超声介导下经皮射频消融术治疗儿童肾素瘤1例病例报告并文献复习

Ultrasound-guided percutaneous radiofrequency ablation for the treatment of reninoma in a child: a case report and literature review

摘要

目的 探讨肾素瘤的临床表现、分型、治疗及预后情况。方法 回顾性分析河北医科大学第二医院2023年收治的1例肾素瘤患儿的临床资料，分享诊疗经验，并结合相关文献报道总结分析肾素瘤的临床表现、分型、治疗及预后情况。结果 行相关辅助检查后高度疑诊右肾毒瘤，患儿接受了超声介导下经皮射频消融术，术后病理示：球旁细胞瘤。术后血压波动于115～138/80～90 mmHg（1 mmHg=0.133 kPa），头痛症状未复发。结论 肾素瘤是一种罕见的能分泌大量肾素继而引起继发性高血压的肾良性肿瘤，超声介导下经皮射频消融术在治疗肾素瘤方面具有一定的应用价值及临床意义。

Abstract

Objective To investigate the clinical manifestations, classification, treatment and prognosis of reninoma. Methods A retrospective analysis was conducted on the clinical data of a pediatric patient diagnosed with reninoma at our hospital in 2023. The clinical manifestations, classification, treatment and prognosis were summarized in combination with literature review. Results The patient underwent ultrasound-guided percutaneous radiofrequency ablation, with postoperative pathology indicating a juxtaglomerular cell tumor. Following the procedure, the patient's blood pressure fluctuated between 115-138/80-90 mmHg, and symptoms of headache did not recur. Conclusion Reninoma, characterized as an uncommon benign renal tumor that secretes renin, has the potential to lead to secondary hypertension. The application of ultrasound-guided percutaneous radiofrequency ablation demonstrates considerable clinical efficacy and importance.

关键词

肾素瘤 / 儿童 / 继发性高血压 / 超声介导 / 射频消融术

Key words

reninoma / child / secondary hypertension / ultrasound-guided / radiofrequency ablation

参考文献

[1] KIM JH, KIM JH, CHO MH, et al. Reninoma: a rare cause of curable hypertension[J]. Korean J Pediatr, 2019, 62(4): 144-147.

[2] ROBERTSON PW, KLIDJIAN A, HARDING LK, et al. Hypertension due to a renin-secreting renal tumour[J]. Am J Med, 1967, 43(6): 963-976.

[3] WONG L, HSU TH, PERLROTH MG, et al. Reninoma: case report and literature review[J]. J Hypertens, 2008, 26(2): 368-373.

[4] DONG D, LI H, YAN W, et al. Juxtaglomerular cell tumor of the kidney-a new classification scheme[J]. Urol Oncol, 2010, 28(1): 34-38.

[5] TRNKA P, ORELLANA L, WALSH M, et al. Reninoma: an uncommon cause of Renin-mediated hypertension[J]. Front Pediatr, 2014, 2: 89.

[6] GIL NS, HAN JY, OK SH, et al. Anesthetic management for percutaneous computed tomography-guided radiofrequency ablation of reninoma: a case report[J]. Korean J Anesthesiol, 2015, 68(1): 78-82.

[7] GERVAIS DA, MCGOVERN FJ, WOOD BJ, et al. Radiofrequency ablation of renal cell carcinoma: early clinical experience[J]. Radiology, 2000, 217(3): 665-672.

[8] 郭芳, 李佳, 陈磊, 等. 超声引导下经皮肾脏肿瘤射频消融术的早期经验[J]. 肿瘤影像学, 2018, 27(4): 279-284.

[9] KWAN KG, MATSUMOTO ED. Radiofrequency ablation and cryoablation of renal tumours[J]. Curr Oncol, 2007, 14(1): 34-38.

[10] ARON M, GILL IS. Renal tumor ablation[J]. Curr Opin Urol, 2005, 15(5): 298-305.

[11] LYRDAL D, ANDERSSON M, HELLSTRÖM M, et al. Ultrasound-guided percutaneous radiofrequency ablation of small renal tumors: Clinical results and radiological evolution during follow-up[J]. Acta Radiol, 2010, 51(7): 808-818.

[12] VELTRI A, CALVO A, TOSETTI I, et al. Experiences in US-guided percutaneous radiofrequency ablation of 44 renal tumors in 31 patients: analysis of predictors for complications and technical success[J]. Cardiovasc Intervent Radiol, 2006, 29(5): 811-818.

[13] HUI GC, TUNCALI K, TATLI S, et al. Comparison of percutaneous and surgical approaches to renal tumor ablation: metaanalysis of effectiveness and complication rates[J]. J Vasc Interv Radiol, 2008, 19(9): 1311-1320.