肾上腺皮质腺癌3例临床病理观察

Adrenal cortical carcinoma: a study of 3 cases and review of literature

目的探讨肾上腺皮质腺癌(Acc)的临床病理学特点。方法对3例肾上腺皮质腺癌的临床表现、大体及组织学特征、免疫组化等进行观察,并复习相关文献。结果 3例患者中男性2例,女性1例,平均年龄53岁(40~62岁);病变均位于左侧肾上腺。2例有Cushing综合征的内分泌临床症状,1例无明显内分泌症状。镜下肿瘤呈巢状、片状分布,细胞大小不等,细胞核异型明显,可见肿瘤侵犯包膜及血管。免疫组化:肿瘤细胞Syn和NSE(+)。结论肾上腺皮质腺癌是一种较罕见的恶性肿瘤,诊断应结合临床资料和影像学表现,并需与多种良、恶性肾上腺肿瘤鉴别。肾上腺皮质腺癌预后很差,治疗首选根治性切除手术。

Objective To analyze the clinical and pathologic features of adrenal cortical carcinoma. Metheds Three cases of adrenal cortical carcinoma were studied with histology and immunohistochemical staining,and its clinical and pathological findings were further analyzed with review of literature. Results Among 3 cases,2 were males and one was female with mean age of 53 years（ ranged 40- 62 years）. The 3 cases were all located at the left adrenal gland. In all 3cases,2 cases had endocrine clinical manifestation of Cushing＇s syndrome,the other dit not. Microscopically,the tumer cells arranged in nests and flake with variant size,prominent unclear atypia. The tumor invasion of capsule and blood vessels was noted. Immunophenotypically,the tumer cells were positive for Syn and NSE. Conclusion Adrenal cortical carcinoma is arare malignant neoplasm. The clinical and radiologic findings must be known for differential diagnosis from other adrenal tumors. Adrenal cortical carcinoma has a worse prognosis,and radical surgery is the preferred treatment for this disease.