原发性腹膜后副神经节瘤3例诊治体会

Experience of diagnosis and treatment of 3 cases of primary retroperitoneal paraganglioma

目的：探讨原发性腹膜后副神经节瘤的临床诊断、治疗特点。方法：回顾性分析本院近3年收治的3例原发性腹膜后副神经节瘤患者的相关资料。男1例,女2例,年龄52.6±15.04岁,均有明显的高血压症状（血压140～230/90～170 mmHg）,血去甲肾上腺素为（981.80～1982.63 pg/ml）。结果：3例均接受手术治疗,完整切除肿瘤。2例为单发肿瘤均位于左侧肾门腹膜后主动脉旁,1例为双侧肿瘤,其中左侧多发,于左肾上下极平面各有一肿瘤。病理诊断均为副神经节瘤。2例随访15～36个月,1例血压正常,1例血压轻度升高（140～155/90～105 mmHg）,复查CT未发现肿瘤复发;1例患者术后6 d血压115～135/75～90 mmHg。结论：腹膜后副神经节瘤强调术前定位定性诊断,要求充分术前准备和提高手术操作技巧,手术完整切除是根本治疗方法。

Objective： To explore the characteristics of clinical diagnosis and treatment of primary retroperitoneal paraganglioma. Methods： The data of 3 cases of primary retroperitoneal paraganglioma in our hospital were retrospectively analyzed. They were 1 male and 2 females and mean age was 52.6 ± 15.04 years. All3 cases had obvious symptoms of high blood pressure（140 ～ 230/90 ～ 170 mmHg）,and high blood norepinephrine. Results： All 3 cases underwent surgical treatment and the tumors were resected completely. 2 cases had single tumor located in the left side of the renal hilum by the retroperitoneal aorta, 1 case had bilateral tumors,that on the left side was multiple,located in the upper and lower pole respectively on a plane of the left kidney.Pathological diagnosis confirmed paraganglioma. 2 cases were followed up for 15 ～ 36 months： 1 case the blood pressure turned normal, the other had moderately elevated blood pressure（140 ～ 155/90 ～ 105 mmHg）. The reexamined CT found no tumor recurrence. And 6 days after the operation, the blood pressure in one patient was115 ～ 135/75 ～ 90 mmHg. Conclusions： The treatment of retroperitoneal paraganglioma emphasizes preoperative localization and qualitative diagnosis, sufficient preoperative preparation and improvement of the operation skills. Complete resection is the ultimate treatment.