嗜铬细胞瘤6例分析

Six cases of pheochromocytoma

目的分析嗜铬细胞瘤的临床特点,探讨其诊治方法。方法回顾性分析6例住院患者的临床资料,复习近年嗜铬细胞瘤诊治文献。结果6例患者中高血压5例,其中阵发性高血压4例,头痛3例,心悸2例,多汗2例,心悸并多汗1例,呈三联征者1例。有腹块者2例,血尿者2例,继发糖尿病1例。行生化检查者2例,超声检查6例及CT检查5例均为阳性。病变位于肾上腺者3例,其中右侧者2例;肾上腺外者3例,其中膀胱2例,腹主动脉旁1例。符合恶性3例,恶性瘤患者年龄较轻,2例异位。术前误诊3例,均为肾上腺外病变。5例手术,3例治愈。结论嗜铬细胞瘤临床表现缺乏特异性,易于误诊,对可疑患者进行敏感性高、特异性强的生化筛选是减少误诊的重要手段。

Objective To analyse clinical characteristics of pheochromocytoma inpatients and explore the methods of diagnosis. Methods Clinical data of 6 patients with pheochromocytoma diagnosed and treated since 1994 were studied,and literatures about pheochromocytoma in recent years were reviewed. Results Of all 6 patients ,5 with hypertension and paroxysmal hypertension 4 cases,3 attacked of headache, 2 palpitation, 2 diaphoresis, 1 palpitations and diaphoresis, 1 with the triad symptoms（headache,sweating attacked and tachycardia）, and 1 with diabetes. Two patients with abdominal＇mass and 2 another with hematuria. Five patients with sonography and CT weve positive. Of 3 cases located the adrenal, 2 was on fight side. Of all 3 cases of extraadrenal（2 in bladder, 1 nearby abdomen aorta）were misdiagnosed before operation. It was 3 eases of pheoehromoeytoma that was conformed to be malignant,and the average age of malignant was lower than the benign. Conclusion Pheochromoctyoma is usually misdiagnosed because of lack performance of specificity. It is of vital importance for suspicious high - risk patient to be performed biochemical screening tests with higher sensitivity and higher speciality in order to reducing misdiagnosis.