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患者男,24岁,因“上腹部隐痛伴恶心,发现左肾肿块10d”于2003-10-25入院。CT检查为左肾肿瘤(18cm×15cm),于2003-12-3行左肾及肿瘤切除术,术中见肿瘤(20cm×14cm×10cm)表面有薄层包膜,重1.7kg。病理诊断:左肾上极圆细胞型脂肪肉瘤。术后肾功能正常。术后20d开始局部放疗:Dt50Gy/25F/5W;术后第5个月发现肺部散在转移,行化疗(方案:长春新碱3g,1次/d、环磷酰胺600mg,1次/d、5-氟尿嘧啶25mg1～2次/d),共5个疗程;术后第30个月超声:右肝后叶(1.7cm×1.7cm)转移,胸部X线片肺部转移加重(图1);术后35个月出现肾功能
Male patient, 24 years old, because of “abdominal pain with nausea and found that the left kidney mass 10d ” was admitted to hospital on October 10, 2003. CT examination for the left kidney (18cm × 15cm), left renal and tumor resection in 2003-12-3, the surgery see the tumor (20cm × 14cm × 10cm) surface thin coating, weighing 1.7kg. Pathological diagnosis: the left kidney on the great cell type liposarcoma. Postoperative renal function is normal. The local radiotherapy was started at 20 days after operation: Dt50Gy / 25F / 5W; the lungs were scattered and metastasized at the 5th month after the operation. The regimens were as follows: vincristine 3g, once daily, cyclophosphamide 600mg once daily, 5-Fluorouracil (25 mg once or twice a day) for 5 courses. At the 30th month after operation, ultrasound was performed: the posterior lobe of the right liver (1.7 cm × 1.7 cm) was transferred, and the chest radiographs showed pulmonary metastasis (Figure 1). After 35 months of renal function