吉林大学学报（医学版）2026，Vol.52Issue(3)：821-827,7.DOI:10.13481/j.1671-587X.20260324
原发性肾血管肉瘤伴多次腹腔出血1例报告及文献复习
Primary renal angiosarcoma with multiple abdominal haemorrhages:A case repert and literature review
摘要
Abstract
Primary renal angiosarcoma(RA)is clinically rare and highly aggressive,and is easily misdiagnosed at the early stage.A 70-year-old female patient admitted to our hospital with sudden severe pain in the right lower abdomen for 10 h was reported.Contrast-enhanced whole abdominal CT showed right renal rupture with active retroperitoneal hemorrhage,and emergency right nephrectomy was performed.Postoperative pathological examination confirmed moderately differentiated RA;immunohistochemical staining results showed that CD31,CD34,and ETS-related gene protein(ERG)were diffusely strongly positive,and the Ki-67 index was 60%.Within one month after surgery,the patient experienced two sudden episodes of massive abdominal hemorrhage(>1 000 mL),which were controlled by embolization of the right hepatic artery and adrenal artery,respectively.Subsequent treatments including cisplatin chemotherapy and disitamab vedotin combined with toripalimab were attempted,but liver metastasis still occurred after 7 weeks.The patient died 3 months after diagnosis.When elderly patients present with spontaneous renal rupture complicated by retroperitoneal hemorrhage,RA should be included in the differential diagnosis.Arterial embolization can be used for emergency hemostasis but is difficult to curb tumor progression,while current chemotherapy and immunotherapy regimens have limited efficacies,and there is an urgent need to explore targeted combination therapy.关键词
肾血管肉瘤/原发性肾脏恶性肿瘤/腹腔出血/肾切除术/免疫治疗Key words
Renal angiosarcoma/Primary renal malignancy tumor/Abdominal hemorrhage/Nephrectomy/Immunotherapy分类
医药卫生引用本文复制引用
刘长丰,金光俊,王永刚..原发性肾血管肉瘤伴多次腹腔出血1例报告及文献复习[J].吉林大学学报（医学版）,2026,52(3):821-827,7.基金项目
吉林省卫健委卫生科研人才专项项目(2023SCZ66) （2023SCZ66）
