韩键　郭泽雄　陈建帆　林基通

【摘要】 目的：探讨妊娠期肾血管平滑肌脂肪瘤（RAML）的临床特征、诊断及治疗方法。方法：通过回顾性分析1例28岁孕8周的女性RAML患者的临床表现、诊断及治疗方法，结合相关文献复习，探讨该疾病的生物学行为、诊断及治疗方法。结果：CT检查提示肾血管平滑肌脂肪瘤，其最大层面大小约19.1 cm×13.3 cm×31.5 cm，患者在施行选择性肾动脉栓塞术的基础上进行了肿瘤剜除术，并且在术后2个月的随访中没有发现复发迹象。结论：妊娠期肾血管平滑肌脂肪瘤临床上少见，患者常把腹部的隆起误认为妊娠的正常现象而延误疾病的诊治。对于处于备孕期患有肾血管平滑肌脂肪瘤的女性，应采取积极的预防性治疗措施。

【关键词】 肾肿瘤; 血管平滑肌脂肪瘤; 妊娠期

doi：10.14033/j.cnki.cfmr.2019.14.087 文献标识码 B 文章编号 1674-6805（2019）14-0-03

A Case Report and Literature Review of Giant Multiple Renal Angiomyolipoma in Pregnancy/HAN Jian，GUO Zexiong，CHEN Jianfan，et al.//Chinese and Foreign Medical Research，2019，17（14）：-188

【Abstract】 Objective：To explore the clinical characteristics and analyze the diagnosis and treatment of renal angiomyolipoma（RAML） in pregnancy.Method：We retrospectively reported a case of 28 years old woman with a giant multiple RAML at 8 weeks of pregnancy，and reviewed the relevant literatures.The biological behavior of RAML was recorded，the diagnosis and treatment of these lesions were discussed.Result：RAML was suspected by computed tomography（CT），which showed the tumor was about 19.1 cm×13.3 cm×31.5 cm，and the patient underwent enucleation of the lesion follow by selective renal arterial embolization.The patient was uneventful after the operation and remains well，with no evidence of recurrence over 2-mouth follow-up.Conclusion：The cases of RAML in pregnancy are rare，patients often consider the enlargement of abdomen is normal phenomenon of pregnancy.Therefore，diagnosis and treatment is delayed.Prophylactic treatment is necessary for women who are ready to get pregnant.

【Key words】 Kidney neoplasms; Angiomyolipoma; Pregnancy

First-authors address：The First Affiliated Hospital of Jinan University，Guangzhou 510632，China

腎血管平滑肌脂肪瘤（RAML）又称肾错构瘤，是由异常血管组织、平滑肌和脂肪3种组织按照不同比例构成的肾脏良性错构组织肿瘤。RAML临床症状多不明显，患者常因体检或者巨大肿瘤压迫邻近脏器产生症状而就诊。妊娠期并发肾巨大血管平滑肌脂肪瘤更属罕见，患者常误认腹部增大为正常妊娠期表现而耽误就诊。笔者所在医院收治1例罕见妊娠期巨大血管多发平滑肌脂肪瘤病例，报告如下。

1 病例介绍

1.1 一般资料

患者女性，28岁，孕8周，因“产检发现腹腔占位病变1 d”

入院。查体：腹饱满，右侧腹可触及巨大肿块。上缘达肝下，下缘达右侧髂窝，横径超过中线，质稍硬，表面光滑，边界清楚，无压痛和反跳痛，右侧腹部叩诊呈浊音，左侧呈鼓音。……