良恶性嗜铬细胞瘤的鉴别诊断与治疗

Benign and malignant pheochromocytoma

为了提高良恶性嗜铬细胞瘤的诊治水平，报告１９５９～１９９４年收治嗜铬细胞瘤病人６６例，良性５１例，恶性１５例。比较良恶性肿瘤临床表现、影像学特点、术中所见、术后病理及随访情况，认为恶性嗜铬细胞瘤常见于男性，都有高血压病史，肿瘤直径大于７ｃｍ多见，内部不均匀，肾上腺结构消失，可以有淋巴结肿大或远处转移的表现；术中可见肿瘤不规则，侵犯周围组织，肿瘤内部可有出血坏死；恶性嗜铬细胞瘤术后复发、转移率高。一些表现为良性的肿瘤也应定期随访，有可能为恶性肿瘤，出现复发或转移。

From 1959 through 1994,66 cases of pheochromocytoma were treated, 51 being benign and 15 malignant.Malignant ones occurred more frequently in the male patients with hypertension in all.The diameter of the tumor usualy exceeded 7cm and the tumor mass was nonhemogeneous. The tumor was usualy irregular in shape,invading the surrounding tissue and the normal structure of the effected adrenal gland disappeared.Some bleeding and necrotic area might be seen in the tumor mass.Recurrence and/or metastasis could often be detected in follow up studies.Follow up studies has been mandatory in malignant pheochromocytoma as well as in benign ones.