肾上腺偶发瘤的诊治

The diagnosis and therapy of adrenal incidentalomas

目的探讨肾上腺偶发瘤的诊断步骤和治疗方法的选择。方法回顾性分析手术证实的129例肾上腺偶发瘤的临床资料。结果129例中125例完整切除肿瘤,肿瘤直径1.2-18 cm。嗜铬细胞瘤31例,皮质腺瘤37例,皮质癌9例,转移癌4例,淋巴瘤3例,其他良性肿瘤45例。结论肾上腺偶发瘤中大部分为皮质和髓质肿瘤,因此需在术前做内分泌检查,确定有无功能;对直径大于3 cm的无功能肿瘤及有功能或疑有恶变的需手术治疗;而小于3 cm无功能肿瘤可定期随访。

Objective To discuss the diagnosis and therapeutic methods of adrenal incidentalomas. Methods The data of 129 cases proved by operation were retrospectively analyzed. Results Total tumor removals were performed in 125 cases, the diameter of the tumors being 1.2 - 18 cm. 31 cases were pheochromocytoma, 37 adrenal cortical adenoma, 9 adrenal cortical carcinoma, 4 metastases carcinoma, 3 lymphoma and 45 other benign tumors. Conclusion Most of the adrenal incidentalomas were adrenal cortical and medullary tumors. In order to determine whether hypersecretions existed, endocrine examination should be performed before operation. Surgical operations were performed in those whose diameters of tumors were over 3 cm with nonhypersecretion or those with hypersecretion or malignant trends. But those whose tumors had nonhypersecretions and diameters were less than 3 cm, should be followed up.