恶性嗜铬细胞瘤的诊断与治疗  

Malignant pheochromocytoma:diagnosis and treatment

作　　者：杨德安[1] 李慎勤[1] 李香铁[1] 刘少鸽[1] 王洪伟[1] 韩玮[1] 郝俊文[1] 

机构地区：[1]济南军区总医院泌尿外科

出　　处：《中华外科杂志》1999年第2期104-105,共2页Chinese Journal of Surgery

摘　　要：目的提高对恶性嗜铬细胞瘤的诊治水平。方法对７例肾上腺恶性嗜铬细胞瘤进行回顾性分析。结果本组患者肾上腺嗜铬细胞瘤直径均大于７０ｃｍ，内部结构为不均质，囊实相间；有血儿茶酚胺、尿香草基扁桃酸异常增高而无高血压的分离现象，并伴有进行性消瘦、血沉加快等。结论部分病例组织病理学与临床过程不一致，术后应长期随访。恶性嗜铬细胞瘤复发及转移率高，术后应进行瘤床放疗和全身化疗。Objective To review the experience with the diagnosis and treatment of malignant pheochromocytoma. Methods Between 1986 and 1996,7 patients with malignant pheochromacytoma were analysed. Results Compared with benign pheochromocytoma of adrenal gland, the malignant one usually exceeded 7 0 cm in diameter, irregular in shape,invading the surrounding tissue and the normal structure of the effected adrenal gland disappeared.Bleeding and nocrotic area were seen in tumor mass, even seemed as a cystic lesion with thick wall. In some patients, blood catecholamine and urine VMA significantly elevated without hypertension. The separating phenomenon and progressive weight loss,accelerated ESR were charactoristics of malignant pheochromocytoma. Conclusions In some patients with malignant pheochromocytoma,histological findings are not consistent with their biological behaviors. Follow up studies is mandatory in malignant pheochromocytoma as well as in benign one.Recurrence and/or metastasis after operation often occur in patients with malignant pheochromocytoma.In addition to early diagnosis and surgery,radiotherapy of tumor bed and systematic chemotherapy should be emphasized.

关 键 词：肾上腺肿瘤 嗜铬细胞瘤 诊断 治疗 恶性 

分 类 号：R736.6[医药卫生—肿瘤]