1006例肾上腺肿瘤诊治体会

Diagnosis and treatment of adrenal tumors:a review of 1006 cases

目的 提高肾上腺肿瘤的诊断和治疗水平。 方法 总结 10 0 6例肾上腺肿瘤的诊治经验。 结果 10 0 6例中有功能肿瘤 845例 ( 84.0 % ) ,其中恶性肿瘤 12例 ( 1.4% ) ;无功能肿瘤 161例 ( 16% ) ,其中恶性肿瘤 11例 ( 6.8% ) ;180例肾上腺偶发瘤中发现嗜铬细胞瘤 19例。本组例行肿瘤切除 996例 ,手术探查 10例 ,手术死亡率为 0 .3 %。 结论 肾上腺肿瘤好发年龄为 3 0～ 5 0岁 ,库兴综合征女性明显多于男性。对肾上腺肿瘤应行内分泌检测 ,定位方法首选B超和CT。功能性肿瘤和体积大的无功能肿瘤应行手术治疗 。

Objective To study the diagnosis and treatment of adrenal tumors. Methods 1 006 cases of adrenal tumors treated from 1957 to 2000 were reviewed. Results Of the 1 006 cases of adrenal tumors,845(84.0%) were functional with 12(1.4%) malignant and 161(16%) nonfunctional with 11( 6.8%) malignant.There were 180 incidentaloma including 19 pheochromocytoma.A total of 996 tumors have been surgically removed and 10 cases underwent surgical exploration only.The total mortality rate was 0.3%. Conclusions Adrenal tumors occurred mostly in patients of 30～50 years of age.The prevalence of Cushing syndrome was more in females than in males.Ultrasonography and CT are the method of choice for the localization of the tumor whereas hormone levels should be determined both in the symtomatic and asymtomatic patients with adrenal tumors.Functional adrenal tumors and solid incidentaloma of large size should be surgically removed while asymtomatic incidentaloma less than 3 cm in size could be observed and followed up and surgery might be undertaken when indicated.