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肾上腺偶发瘤128例临床分析 被引量:5

Clinical analysis of 128 cases of adrenal incidentalomas
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摘要 目的提高肾上腺偶发瘤的早期诊断与鉴别诊断水平,指导临床治疗。方法回顾性分析1996年3月至2010年3月在我院健康体检或因肾上腺以外疾病就诊丽发现的128例肾上腺偶发瘤患者的资料。男60例,女68例。年龄20-75岁,平均50岁。肿瘤直径〈3cm者63例,3~6cm者56例,〉6cm者10例。128例患者均行血生化、电解质和肾上腺皮、髓质代谢检测及腹部超声、CT检查;6例行MRI检查。128例均行手术治疗。结果128例术后病理诊断肾上腺皮质腺瘤85例,嗜铬细胞瘤13例,肾上腺囊肿8例,神经节瘤、髓样脂肪瘤各7例,肾上腺皮质结节状增生4例,肾上腺皮质癌2例,肾上腺皮质嗜酸细胞瘤、神经鞘瘤、肾上腺脂肪肉瘤各1例。其中1例嗜铬细胞瘤患者术中死于低血压休克,未计入总例数。结论肾上腺偶发瘤术前定性诊断困难,对于直径〉6cm及功能性偶发瘤应积极手术治疗。 Objective To improve the early diagnosis and differential diagnosis of adrenal ineidentalomas to guide clinical management of this disease. Methods One hundred and twenty-eight cases were diagnosed as adrenal incidentalomas due to health examination or treatment of other than adrenal disease, including 60 males and 68 females, whose ages were between 20 and 75 years, with a mean age of 50 years. Tumor diamer:〈3 cm 63 cases, 3-6 cm 6 cases, 〉6 cm 10 cases. 128 patients all had biochemical and electrolyte examination, adrenal cortex and medulla biochemical testing, abdominal ultrasound and CT examination, 6 cases with MRI examination. Surgery and post operative pathological examination were performed in all patients. Results Post operative pathology finally diagnosed adrenocortical adenoma in 85 cases, pheochromocytoma in 13 cases, adrenal cyst in 8 cases, paraganglioma and myelolipoma in 7 cases respectively, adrenal nodular hyperplasia in 4 cases, adrenocortieal carcinoma in 2 cases, adrenocortical oncocytoma, cellular Schwannoma and adrenal liposar- coma in 1 case, respectively. One case of pheochromocytoma patients died of intraoperative hypoten- sion, which is not included in the total number. Conclusions The preperative diagnosis of adrenal ineidentalomas is difficult. For adrenal incidentalomas with diameter more than 6 cm and those with endocrine function, early surgical treatment is recommended.
出处 《中华泌尿外科杂志》 CAS CSCD 北大核心 2011年第5期292-294,共3页 Chinese Journal of Urology
关键词 肾上腺肿瘤 偶发瘤 嗜铬细胞瘤 皮质醇增多症 腹腔镜 Adrenal neoplasms Incidentaloma Pheochromocytoma Cushing syndrome Laparoscopies
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