肾上腺节细胞神经瘤的诊治分析

Diagnosis and treatment of adrenal ganglioneuroma: clinical characteristics presented and literature reviewed

目的探讨肾上腺节细胞神经瘤的临床特点和治疗方法,提高其诊治水平。方法回顾性分析中山大学附属第三医院泌尿外科收治8例肾上腺节细胞神经瘤患者的临床资料,其中男3例,女5例,年龄26~67岁。肿瘤位于左侧肾上腺3例,右侧5例,瘤体长径2.5~9.7 cm,其中4例影像学检查提示瘤体包绕大血管生长。结果 8例患者临床诊断均为肾上腺节细胞神经瘤,其中6例成功行腹腔镜肾上腺肿瘤切除术,2例随访观察。手术时间45~120 min,出血量30~450 ml,无输血。1例右侧肾上腺肿瘤包绕下腔静脉生长的患者,术中游离肾上腺瘤体出现下腔静脉损伤,腔镜下予以缝合修补成功,无中转开放手术病例。6例术后病理均证实为肾上腺节细胞神经瘤。术后随访3个月~5年,无肿瘤复发病例。结论肾上腺节细胞神经瘤为神经源性良性肿瘤,有钻缝和包绕大血管生长的特性,腹腔镜手术切除虽是一种安全有效的术式,但术中应注意避免损伤邻近大血管。

Objective To evaluate the clinical characteristics, diagnosis and treatment of adrenal ganglioneuroma. Methods The clinical data of 8 cases of adrenal ganglioneuromas at our hospital were reviewed retrospectively. Amang these 8 cases, 5 tumors were located in the right side while 3 were in the left side. The age was 26 to 67 years old.The mean tumor size was 5.0 cm, ranged from 2.5 cm to 9.7 cm. Results Among these 8 cases, 6 cases were performed laparoscopic adrenalectomy successfully. The other two cases were followed up without surgical intervention. The operative time was 45-120 min and blood loss was 30-450 ml without blood-transfusion. one patient whose inferior vena cava has been injured during the laparoscopic adrenalectomy and finally has been repaired with laparoscope successfully.The patients performed operations all diagnosed as adrenal ganglioneuromas by pathology. Eight cases were followed-up 3 months to 5 years. No patient has tumor recurrence. Conclusions Adrenal ganglioneuroma is a benign neurogenic tumor without specific clinic symptoms. Laparoscopic adrenalec tomy is safe and effective, however great vessels nearby must be protected during the operation.