偶发性肾上腺肿瘤29例报告

Adrenal incidentaloma (Report of 29 cases)

为提高偶发性肾上腺肿瘤的诊断和治疗水平，对29例偶发性肾上腺肿瘤进行分析。29例中，手术时偶然发现1例，B超扫描发现25例，CT检查发现28例。28例行手术治疗，1例未手术。结果27例患者痊愈，无术后并发症。提示CT可作为偶发性肾上腺肿瘤首选影像学诊断，B超可作为筛选诊断。偶发性恶性肾上腺肿瘤以转移癌多见，而原发性肿瘤极罕见。对确诊为恶性肿瘤、功能性肿瘤及直径＞4cm的肿瘤应积极采取手术治疗，术中应警惕偶发性嗜铬细胞瘤的潜在危险；对非功能性、直径＜4cm的肿瘤可行CT随访。

29 patients with adrenal incidentaloma were reported in this paper. Of which one case was incidentally found by the operation, 25 cases by B-ultrasonography, 28 cases by CT scan ning. 28 cases were surgically treated. 27 cases were cured. The results showed that CT scanning can be as the first alternative method for imaging diagnosis of adrenal incidentaloma. B-ultrasono graphy can be as a screening method. Among the adrenal incidentaloma, prirnary adrenal carcinorna was rare and metastatic carcinoma was common. Open operation should be performed for malig nant, functional adrenal tumors, and tumors grater than 4 cm in diameter. An asymptomatic pheochromocytoma should be noticed during operation. The tumors smaller than 4 cm might be fol lowed up with CT scanning.