肾上腺神经鞘瘤的诊治特点(附5例报告)

Diagnosis and treatment of adrenal schwannoma(Report of five cases)

目的：探讨肾上腺神经鞘瘤的诊治特点。方法：回顾性分析5例肾上腺神经鞘瘤患者的临床资料，结合文献分析其临床、影像学及病理特点，探讨其治疗及预后。结果：本组5例患者均为体检发现，其中3例曾感患侧腰部不适。人院体检均无特殊发现，与肾上腺有关的血生化检查均为正常。所有患者手术切除肾上腺肿物，术后病理检查证实为肾上腺神经鞘瘤，随访3个月～9年，未见复发或恶变。结论：肾上腺神经鞘瘤来源于肾上腺髓质，为良性肿瘤，较为少见，临床表现缺乏特异性，确诊依赖病理学及免疫组织化学检查。手术切除是主要治疗方法。

Objective： To analyze the key points of diagnosis and treatment of adrenal schwannoma. Method： A retrospective review was conducted for patients with tumors of adrenal schwannoma that were treated from 2004 to 2013. The data of patient file, physical examination, laboratory tests, imaging modalities, operative records, pathological diagnosis and follow-up was collected and analyzed with a complete retrieved review ＇adrenal＂ with schwannoma＂ in PubMed. Result： All five patients were discovered by health check, and three of them once suf- fered from lower back discomfort on the affected side. Adrenal metabolic evaluation was in normal range. Imaging showed large well-defined mass arising from adrenal gland with cystic degeneration. Patients underwent open or laparoscopic adrenalectomy. Histological examination established the diagnosis of adrenal schwannoma. There was no tumor-specific morbidity over the follow-up period of 3-108 months. Conclusion： Adrenal schwannoma is a be nign tumor with inconsistent features of clinical presentation, imaging and biochemical tests. Total excision of tumor is strongly suggested and leads to a favorable outcome. A definitive diagnosis can only be made by histological and immunohistoehemical evaluations.