膀胱嗜铬细胞瘤的临床诊疗

Clinical diagnosis and treatment of bladder pheochromocytoma

目的探讨膀胱嗜铬细胞瘤的临床诊治方案。方法对8例膀胱嗜铬细胞瘤患者的临床诊治情况和院外随访情况进行回顾分析。结果 8例患者就诊时均有血压升高,超声检查均可见膀胱壁肌层等回声包块,CT检查均可见膀胱侧壁有类圆形软组织肿块向腔内突出,MRI检查显示膀胱壁或膀胱三角区有占位灶,膀胱镜检查显示膀胱壁有大包块突入膀胱。术后随访12个月,血浆游离甲氧基肾上腺素平均水平显著低于入院时(P=0.000)。8例患者均接受手术治疗,术后随访12个月,血压均正常,排尿时无心悸、头晕等症状,疾病无复发。结论膀胱嗜铬细胞瘤的临床诊断难度较小,结合临床表现、影像学检查和内镜检查结果可以确诊,膀胱部分切除术为治疗膀胱嗜铬细胞瘤的有效术式,能够有效改善患者预后。

Objective To investigate the clinical diagnosis and treatment of bladder pheochromocytoma. Methods Theclinical diagnosis and outpatient follow-up of 8 patients with bladder pheochromocytoma were retrospectively analyzed.Results A total of 8 patients had elevation of blood pressure at the time of presentation, the ultrasound examination showedequal echo masses at the muscular layer of the bladder wall, CT examination revealed a round soft tissue mass protruding intothe lumen of the bladder, MRI examination showed that there was a lesion in the bladder wall or the bladder triangle,cystoscopy showed there was a large mass in the bladder wall that protruded into the bladder. After 12 months of follow-up,the mean level of plasma free methoxy-adrenalin was significantly lower than that at admission （P=0.000）. All the 8 patientsunderwent surgery, and after 12 months of follow-up, the blood pressure were normal, and there were no symptoms such aspalpitations and dizziness during urination, there were no recurrence of the disease. Conclusion The clinical diagnosis ofpheochromocytoma is less difficulty, and which can be confirmed by clinical manifestations, results of imaging examinationand endoscopy examination. Partial cystectomy is an effective procedure for the treatment of bladder pheochromocytoma,which can effectively improve the prognosis of patients.