肾上腺神经内分泌癌1例临床分析并文献复习  

Adrenal neuroendocrine carcinoma： an analysis of one case and review of literature

作　　者：于俊杰[1] 温儒民[1] 

机构地区：[1]徐州医学院附属医院泌尿外科,江苏徐州221002

出　　处：《徐州医学院学报》2014年第3期161-163,共3页Acta Academiae Medicinae Xuzhou

摘　　要：目的 提高对肾上腺神经内分泌癌的认识及诊疗水平.方法 回顾性分析我院收治的1例肾上腺神经内分泌癌患者的临床资料,结合相关文献进行复习总结.结果 本例患者体检发现右侧肾上腺占位,无高血压等特殊症状,行腹腔镜手术治疗,术后病理为嗜铬细胞瘤,但血压正常.9个月后出现腹壁种植等多发转移,行开放手术探查腹膜后并成功切除腹壁下肿瘤,结合免疫组化及专家会诊,确诊为神经内分泌癌.术后1个月复发,并出现血压升高、乏力症状,按疗程行化疗.结论 肾上腺神经内分泌癌是一种罕见的高度恶性肿瘤,缺乏特异性临床表现,确诊多为晚期,预后差.组织细胞学特点和免疫组化神经内分泌标志物（如NSE等）是诊断的主要依据,早期诊断治疗可能提高预后,晚期患者行化疗等姑息性治疗,可提高患者生活质量,延长生存期.Abstract： Objective To enhance the diagnostic skills of adrenal neuroendocrine carcinoma. Methods A retro spective study was performed to analyze the clinical data from one patient with adrenal neuroendocrine careinoma included in our hospital, in accordance with relevant literature. Results This patient manifested a space occupying lesion in the right adrenal during physical examination, without other specific symptoms including high blood pressure. Then, an lapa roscopic operation was performed, and pheochromocytoma was determined based on pathological data. However, the blood pressure remained normal. Nine months later, multiple metastases including abdominal wall implantation were de tected. Then an open operation was carried out to examine the peritoneum and a tumor under the abdominal wall was sue cessfully removed. With respect to immunohistorical and consultation results, adrenal neuroendocrine carcinoma was di agnosed. Relapse occurred one month after surgery, while hypertension and fatigue appeared. Then chemotherapy was carried out according to the course of treatment. Conclusions Adrenal neuroendocrine carcinoma is a rare and highly malignant tumor, which lacks of specific clinical manifestations. Most patients are diagnosed at a late stage, with poor prognosis. Histological features and immunohistochemical neuroendocrine markers （such as NSE） can be the main evi dence for diagnosis. Early diagnosis and treatment may improve the prognosis. Palliative therapy such as chemotherapy can be adopted for those end stage patients to improve the quality of life and prolong the survival period.

关 键 词：嗜铬细胞瘤 复发 诊断 治疗 肾上腺神经内分泌癌 

分 类 号：R736.6[医药卫生—肿瘤]