Perivascular Epithelioid Cell Tumors: An Analysis Of Clinical Diagnosis And Treatment Of Renal PEComa

Objective: Perivascular epithelioid cell tumors(PEComas)are mesenchymal tumors consisting of histologically and immunohistochemically distinct epithelioid or spindle cells.This tumor has malignant potential,and there is still confused in the selection of preoperative diagnosis and treatment options common at present.This paper aims at the clinicopathological characteristics of PEComa to find a feasible method of preoperative diagnosis and guide the treatment.Methods: A retrospective analysis of 89 cases of renal PEComa diagnosed by pathology admitted to our department from 2012.1to 2019.1 was conducted.Results: Among 89 patients with renal PEComa,the ratio of male to female was 1:7,the largest tumor was 26*20*15cm,and the smallest tumor was 1.1*0.5*0.5cm.7 cases were bilateral space-occupied,all of which were treated by surgery.Among them,41 cases were benign,45 cases had uncertain malignant potential,and 3 cases were malignant.Almost all cases expressed SMA(98.9%),Melan-A(100%)and HMB-45(95.5%),while S-100(26.4%)and Desmin(3.7%)had lower expression rates.In the preoperative imaging diagnosis,the fat component has certain specificity for judging benign and malignant(P<0.05).It is a better choice to judge benign or malignant with 6.15 cm as the cut-off point.Conclusion: Renal PEComa with malignant potential is difficult to diagnose before surgery,and fat content can be used as a diagnostic basis.Using 6.15 cm as the dividing line to judge benign or malignant is better At present,the diagnosis is confirmed mainly by pathological results.Surgical resection is the main treatment,and the prognosis is mostly good.