Objective To evaluate the diagnosis and treatment of left renal vein entrapment syndrome. Methods The clinical data of 10 cases of left renal vein entrapment syndrome were retrospectively analyzed.Their mean age was 24 years (range,14-37 years).Of them 7 cases presented with non-glomerular origin hematuria;2,with orthostatic proteinuria;1 with hematuria accompanied by proteinuria.Color Doppler sonography showed that the dilated segment of the left vein was three-fold than the strictured segment in diameter,and magnetic resonance angiography (MRA) showed that the left renal vein was compressed in 9 cases. Results Stent placement across the left renal vein was performed in 7 cases.Superior mesenteric arteriectomy and replantation were performed in 3 cases.The operations were all successful.Follow-up of 1-5 years showed that the clinical symptoms were improved and urine tests were normal. Conclusions Non-glomerular hematuria or orthostatic proteinuria is frequently found in left renal vein entrapment syndrome.Left renal vein entrapment syndrome can be diagnosed by Doppler sonography,MRA and cystoscopy in the presence of hematuria or proteinuria.Generally,conservative treatment and careful follow-up are conducted in these patients.Surgical and radiologic interventional procedures are effective alternatives for those with glomerular dysfunction and complications.

Objective To analyze the clinical and pathological features of collecting duct carcinoma (CDC) of the kidney. Methods 11 patients with CDC were analyzed,among which 6 were males and 5 were females.Their age ranged from 22 to 67 years old with a mean age of 55.4 cases were found by routine health examination,4 cases were presented with gross hematuria and 3 cases had flank or abdomen pain.The CT scan showed an unclear boundary mass in kidney,with tumor sizes from 2.1 to 8.5 cm ( mean 5.6 cm).Only medullary involvement was present on CT in 3 cases,Medullary and cortical involvement in 5 cases,Medullary and pelvic involvement in 2 cases,and all involvement in 1 case.Infiltrative lesion has expanded kidney but maintains reniform contour.Contrast-enhanced CT scan showed lesion mild to moderate enhancement compared with surrounding parenchyma. Results Radical nephrectomy was performed in 8 cases and palliative nephrectomy in 3 cases.All patients were finally diagnosed by pathology.Grossly,the tumor is often appears gray or white.In HE staining,tumor showed prominent tubular or tubulaopapillary structures with desmoplasia and inflammatory reaction.Occasionally,some tumor cells take on a hobnail appearance.Immunohistochemical examination showed UEA-1 positive in all cases,EMA positive in 9 cases,PNA positive in 8 cases,and HMW-CK positive in 7 cases.Only 2 patients showed positive CD10.7 patients died within 6 to 47 months (mean 12.5 months),2 survived with tumor free for 9 months and 8 years respectively,one lost of follow-up,and one patient with distant metastasis is receiving postoperative chemotherapy. Conclusions Collecting duct carcinoma of the kidney is a rare histological type of renal cell carcinoma,whose final diagnosis depends on histopathological examination.Rapid progression,highly malignant,poor prognosis are the characteristics of this disease.

Teratoma is a rare tumor, mainly occurring in the ovary, sacrococcygeal region, testis, central nervous system and mediastinum, rarely occurring in the kidney, and adult immature teratoma originating in the kidney is extremely rare. A case of adult left renal immature teratoma was reported in this paper. After radical nephrectomy, pathological examination found that the tumor tissue contains malignant epithelial tissue and a small number of brain tissue. BEP regimen chemotherapy was performed after operation.The patient was followed up for 26 months, and died of organ failure caused by systemic metastasis.