Stečena cistična bolest i karcinom bubrega kod bolesnika na hemodijalizi

Mirjana Mijušković; Novak Milović; Božidar Kovačević; Dragan Jovanović; Dara Stefanović; Ljiljana Ignjatović; Brankica Terzić; Jelena Tadić Pilčević; Marijana Petrović; Dejan Pilčević; Kataina Obrenčević; Snežana Cerović

doi:10.2298/5656

Mirjana Mijušković Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Novak Milović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Urology, Military Medical Academy, Belgrade, Serbia
Božidar Kovačević Institute of Pathology, Military Medical Academy, Belgrade, Serbia
Dragan Jovanović Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Dara Stefanović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Institute of Radiology, Military Medical Academy, Belgrade, Serbia
Ljiljana Ignjatović Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
Brankica Terzić Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
Jelena Tadić Pilčević Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Marijana Petrović Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Dejan Pilčević Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
Kataina Obrenčević Centar for Solid Organ Transplantation, Military Medical Academy, Belgrade, Serbia
Snežana Cerović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Institute of Pathology, Military Medical Academy, Belgrade, Serbia

DOI: https://doi.org/10.2298/5656

Ključne reči: renal dialysis||, ||bubreg, neoplazme, kidney diseases, cystic||, cistični, hemodyalisis||, ||hemodijaliza, nephrectomy||, ||nefrektomija, treatment outcome||, ||lečenje, ishod,

Sažetak

Uvod. Karcinom bubrega (renal cell carcinoma – RCC) nastaje iz renalnih epitelnih ćelija tubula i čini oko 3,8% svih maligniteta kod odraslih. Incidencija RCC je u stalnom porastu i iznosi 0,6 do 14,7 na 100 000 stanovnika. Bolesnici sa terminalnom bubrežnom insuficijencijom i stečenom cističnom bolešću bubrega su u povećanom riziku od razvoja RCC tokom lečenja dijalizom ili nakon transplantacije bubrega. Prikaz bolesnika. U radu su prikazana 3 bolesnika lečena hemodijalizom sa stečenom cističnom bolešću bubrega koja je bila udružena sa razvojem RCC. Kod svih bolesnika tumor je bio asimptomatski i otkriven je ultrazvučnim pregledom kod dva bolesnika, a kod jednog patohistološkom analizom tkiva bubrega odstranjenog nefrektomijom. Kod sva tri bolesnika bolest je bila organ-ograničena u vreme postavljanja dijagnoze i nije zahtevala primenu dodatne terapije nakon hirurškog lečenja. Tokom perioda praćenja od 6 meseci do 7 godina nakon nefrektomije, nije dijagnostikovano postojanje lokalne rekurencije ili metastaza RCC. Zaključak. Stečena cistična bolest bubrega predstavlja predisponirajući faktor razvoja RCC kod bolesnika na dijalizi i zahteva redovne ultrazvučne kontrole abdomena u cilju postavljanja rane dijagnoze maligniteta. Prognoza kod bolesnika sa terminalnom bubrežnom insuficijencijom i RCC u najvećoj meri je dobra jer su karcinomi bubrega kod ovih bolesnika, uglavnom, indoletnog toka.

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