肾上腺皮质嗜酸细胞癌的临床特点及诊疗对策(附2例报告)

Clinical features and treatment strategy for adrenocortical oncocytic carcinoma(Report of 2 cases)

目的:总结肾上腺皮质嗜酸细胞癌(adrenocortical oncocytic carcinoma,AOC)临床特点、诊断标准、治疗方法以及预后。方法:报告AOC 2例,并通过Pubmed、CNKI数据库进行文献复习。结果:1例无症状女患者,CT提示左肾上腺9cm肿物;另1例患者男,腰疼,左肾上腺30cm肿物。2例患者相关内分泌检查均无异常。女患者接受腹腔镜左肾上腺肿物切除术,男患者接受经腹开放左肾上腺肿物切除。2例术后病理均提示肿物以嗜酸性细胞为主,有核异型性、核分裂相>5/HPF,包膜及血管浸润,免疫组化提示组织来源于肾上腺皮质。根据Bisceglia改良标准,AOC诊断成立。结论:AOC临床罕见,目前国内外共24例散发报道,治疗以手术为主,病理检查为其主要诊断方法,术后辅助治疗的方案及效果尚无定论,AOC恶性度低,预后较好。

Objective：To study the clinical features,diagnosis criteria, treatment strategy and prognosis of adre- nocortical oncoeytic carcinoma（AOC）. Method： We reported two cases of AOC, and review the literature from Pubmed and CNKI. Result：Case 1 was a middle age female had a 9 cm left adrenal tumor detected by CT without any complain. The left retroperitoneal laparoscopic adrenalectomy was preformed soon later. Another case was a middle age male with mild abdominal pain was detected a 30cm left adrenal tumor by CT. the open adrenalectomy was preformed. Both of two cases, the pathologic finding exhibited showed abundant eosinophilic granular cyto- plasm. Atypical mitotic figures and venous and capsular invasions were evidenced too. Immunohistochemistry showed the tumor divided from adrenoeortex, The AOC was diagnosed by ＂Bisceglia modified system＂. Conclusion： AOC is extremely rare. There were only 24 cases reported in English and Chinese literature. Operation is the first treatment choice. Postoperative adjuvant therapy is still controversial. The prognosis of AOC is good because of low malignancy.