膀胱副神经节瘤4例诊治分析及文献复习  

Diagnosis and treatment of bladder paraganglioma: report of four cases with review of literature

作　　者：叶烈夫[1,2] 许庆均[1,2] 何延瑜[1,2] 朱庆国[1,2] 李涛[1,2] 朱伟[1,2] 张志刚[1,2] 黄水通[1,2] 胡敏雄[1,2] 叶世华[1,2] 陈松茂[1,2] 陈如[1,2] 

机构地区：[1]福建医科大学省立临床学院 [2]福建省立医院泌尿外科,福州350001

出　　处：《现代泌尿生殖肿瘤杂志》2013年第2期79-83,共5页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨膀胱副神经节瘤的临床特点及诊治经验。方法回顾性分析我院2010年5月至2011年7月诊治的4例膀胱副神经节瘤患者的临床资料。其中女3例,男1例,年龄41～63岁。临床表现为高血压者2例,间歇性无痛肉眼血尿者1例,无症状者1例。4例中仅1例患者血去甲肾上腺素值明显高于正常。4例均行CT及膀胱镜检查。术前均按嗜铬细胞瘤做准备。结果 3例行膀胱部分切除术,1例行肿瘤剜除术。术前2例高血压者术后血压恢复正常。术后随访6～20个月,未见肿瘤复发。结论膀胱副神经节瘤临床表现常缺乏特异性,膀胱非上皮肿瘤鉴别诊断时应考虑本病可能。血儿茶酚胺测定对膀胱副神经节瘤的定性诊断价值有限。CT和膀胱镜检查在肿瘤定位、定性诊断中起重要作用。膀胱部分切除术是首选的治疗方法,疗效确切,术前应充分扩容。Objective To investigate the clinical feature, diagnosis and treatment of bladder paraganglioma. Methods Clinical data of 4 cases of bladder paraganglioma treated during May 2010 to July 2011 were retrospectively analyzed and the literatures were reviewed. Patients included 3 females and 1 male, age ranged form 41 to 63 years old. 2 Cases presented with hypertension, one with intermittent gross hematuria, the other one had no symptom. Only 1 patient had significantly elevated plasma catecholamines. Pelvic CT scan and cystoscopy were performed in all 4 patients. All patients received preoperative adrenergic blockade and volume expansion. Results Three of them underwent partial cystectomy, one received tumor enucleation. Diagnosis of bladder paraganglioma was confirmed by histopathological and immunohistochemical examination. Blood pressure returned to normal in 2 cases with preoperative hypertension. Patients were followed up for 6 months to 20 months, none had tumor recurrence. Conclusions Bladder paraganglioma usually present with nonspecific clinical signs and symptoms. It should be considered as a differential diagnosis to non-epithelial bladder tumor. Plasma catecholamines measurement provides only limited value in qualitative diagnosis of bladder paraganglioma. CT and cystoscopy play an important role in diagnosing and lo- calizing the tumor. Partial cystectomy is first choice in treating paraganglioma of bladder for excel lent results. Preoperative volume expansion is essential to reduce perioperative mortality and morbidity.

关 键 词：副神经节瘤 膀胱 诊断 治疗 

分 类 号：R737.14[医药卫生—肿瘤]