肾上腺转移癌45例报告

Metastatic Adrenal Carcinoma(Report of 45 Cases)

目的:总结肾上腺转移癌的临床特点与诊治体会。方法:回顾性分析1996年12月～2010年2月收治的肾上腺转移癌患者45例临床资料:原发肿瘤包括肺癌23例(51.1%),肝癌5例(11.1%),肾癌5例(11.1%),乳腺癌4例(8.9%),黑色素瘤2例(4.4%),其他肿瘤6例(13.3%)。临床表现为全身乏力、消瘦、贫血或低热16例,患侧腰背部胀痛8例,高血压6例。均行B超、CT、MRI及正电子发射断层扫描(PET)检查确诊。35例行手术治疗,10例放弃手术。结果:完整切除转移癌者30例获得随访,生存6～62个月,平均34.2±4.7个月,最长存活已5年2个月;5例失访。10例放弃手术者中,6例获得随访,生存4～8个月,平均6.3±2.7个月,均死于肿瘤晚期或多发转移。结论:对原发肿瘤应重视术中及术后肾上腺部位的检查及随访。B超及CT是诊断肾上腺转移癌的重要检查方法,PET对诊断肾上腺转移癌有较高的临床价值。完整切除肾上腺转移灶可延长患者生存期,但需严格控制适应证。

Objective： To summarize the diagnosis and management of adrenal metastatic carcinoma. Methods： 45 cases with metastatic tumor in the adrenal glands were analyzed retrospectively from Dec. 1996 to Feb. 2010 . Lung was the most common primary tumor site（51.1%）, followed by the renal cell carcinoma（11. 1%）, liver cancer（11.1%）, breast cancer（8.9%）, melanin tumor（4.4%）, and other carcinoma （13.3%）, respectively. Most patients with metastatic adrenal carcinoma have no special clinic manifestation. 35 cases were surgically removed the tumors and 10 cases gave up operation, some of the cases received adjuvant therapy after operation. Resuits：30 cases of complete resection of metastatic cancerwere followed, with an average survival of （34 . 2 ± 4 . 7） months, ranged from 6 to 62 months. The longest survival was 5 years and 2 months; 5 patients were lost. Of 10 cases without surgery, 6 cases were followed with an average of （6 . 3 ± 2 . 7）months, ranged from 4 to 8 months. All 6 cases died of cancer advance or metastases. Conclusions：Adrenal gland is a common site of metastatic carcinoma. Ultrasonography and CT are important diagnosis methods for metastatic adrenal carcinoma. Operation is still effective and long-term survival may be achieved for those well selected patients, but surgical indication must be strictly monitored.