嗜铬细胞瘤的诊治

Approach to the patient of pheochromocytoma： the diagnosis and treatment

一例34岁男性因波动性高血压疑为嗜铬细胞瘤而转至本科就诊。该患者临床表现典型，入院查血浆甲氧基肾上腺素（MN）及甲氧基去甲肾上腺素（NMN）均明显升高，CT和PET—CT检查均发现左侧。肾上腺占位，诊断为嗜铬细胞瘤。术前予以甲磺酸多沙唑嗪控释片4mg／d口服2周，血压平稳，在腹腔镜下行左侧肾上腺肿瘤切除术。术后病理提示嗜铬细胞瘤，MN、NMN、血压恢复正常，症状缓解。该患者术后随访3年，血压、血浆MN、NMN水平均正常，肾上腺CT未见肿瘤复发。

A 34-year-old male patient with suspected pheochromocytoma was referred to our department for paroxysmal hypertension. Pheochromocytoma was confirmed by very high plasma nor-metanephrine （ NMN ） and metanephrine（MN）. Contrast CT of the adrenal disclosed a 3.0 cm × 3.0 cm mass in the left adrenal. ^18 F-FDG-PET- CT showed high uptake only in the left adrenal. When the patient＇s blood pressure was well controlled with 4 mg/d doxazosin for 2 weeks, surgery was then performed under laparoscopy. A round solid left adrenal pheochromocytoma was resected. After surgery, plasma MN and NMN levels returned to normal, and the patient was free of clinical symptoms with normal blood pressure. This patient has been followed 3 years with normal blood pressure, MN, and NMN levels, without tumor recurrence shown by adrenal CT.