肾上腺恶性嗜铬细胞瘤并下腔静脉瘤栓形成的诊治分析(附5例报告)

Diagnosis and treament of malignant adrenal pheochromocytoma with inferior vena cava tumor thrombus (Report of 5 cases)

目的:探讨肾上腺恶性嗜铬细胞瘤并下腔静脉瘤栓形成的临床诊疗经验。方法:回顾性分析5例肾上腺恶性嗜铬细胞瘤并下腔静脉瘤栓形成患者的临床资料:患者24h尿VMA均升高,尿儿茶酚胺定性试验均阳性;CT、CTA、下腔静脉造影检查发现下腔静脉充盈缺损。5例均在全麻下行肾上腺肿瘤切除加下腔静脉瘤栓取出术。结果:目前3例生存,另2例分别于术后21个月和36个月死亡。结论:影像学检查(CT、CTA、下腔静脉造影等)对肾上腺恶性嗜铬细胞瘤并下腔静脉瘤栓形成的诊断具有重要意义。根治性肿瘤切除加瘤栓取出术是治疗肾上腺恶性嗜铬细胞瘤并下腔静脉瘤栓形成的有效方法。

Objective：To present our experience on the diagnosis and treatment of malignant adrenal pheochromocytoma with inferior vena cava tumor thrombi. Methods：Clinical data of 5 cases of patients with malignant adrenal pheochromocytoma with inferior vena cava tumor thrombi were restrospectively reviewed. ①Urine VMA level was found elevated and the qualitative test of the urine catecholamine were positive in all cases.②Filling defect was found by CT,CTA and inferior venocavagraphy. Results：All the 5 cases were operated on by resection of the tumor and embolectomy under general anesthesia. Three of them are alive, one died of tumor recurrence 21 months after operation and one after 3 years. Conclusions： Imaging study（CT, CTA, inferior venocavagraphy, and so on） are important for the diagnosis of malignant adrenal pheochromocytoma with inferior vena cava tumor thrombi. Radical resection plus embolectomy is choice of treatment for malignant adrenal pheochromocytoma with inferior vena cava tumor thrombus.