肾上腺肿瘤自发性破裂出血5例报告

Spontaneous hemorrhage of adrenal tumor： 5 cases report

目的提高对肾上腺肿瘤自发性破裂出血的认识及诊治水平。方法回顾性分析2004年1月到2009年3月，共收治5例肾上腺肿瘤自发性破裂出血患者的诊治资料，并进行总结。所有患者均以突发患侧剧烈腰痛急诊，行B超、CT检查发现肾上腺肿块较大，直径4．5cm-12cm不等，平均8．5cm，肿瘤性质均有病理明确。结果5例自发性破裂出血的肾上腺肿瘤中，3例为嗜铬细胞瘤（其中1例失随访），1例肺癌肾上腺转移，1例肾上腺皮质癌。结论肾上腺肿瘤自发出血较为少见，临床表现以突发性患侧腰痛、胸闷、心悸为主，B超、CT是有效的诊断方法。肾上腺肿瘤自发性破裂出血多见于较大功能性肿瘤和恶性肿瘤破裂出血，应在稳定生命体征的情况下，积极手术。

Objectives To improve the diagnosis and treatment of spontaneous hemorrhage of adrenal tumor. Methods From January , 2004 to march, 2005, 5 cases of spontaneous hemorrhage of adrenal tumor were retrospectively analyzed and summarized. All patients felt acute lumbodynia of affected side and were checked by B ultrasound and CT. The adrenal tumors are large and the diameter ranged from 4.5cm - 12cm with the mean of 8. 5cm. The histology of 4 cases was identical by Pathologic examination. Results 5 patients suffered Spontaneous hemorrhage of adrenal tumor. 3 cases were pheochromocytomas and one case was out of follow - up, one cases was adrenal metastasis from lung cancer, one case was adrenocortical carcinoma. Conclusions Spontaneous hemor- rhage of adrenal tumor is very rare. The clinical symptoms were acute lumbedynia of affected side, dyspnea and palpitation. B ultrasound and CT are effective. Spontaneous hemorrhage of adrenal tumor are always secondary to rupture of giant functional tumors and malignant tumors, and operation should be performed after emergency treatment.