肾上腺异时转移癌的临床诊治分析  

Analysis on clinical diagnosis and treatment of metachronous adrenal metastases

作　　者：霍韶军[1] 霍红沙 HUO Shao-jun;HUO Hong-sha(Department of Urological Surgery,Handan Central Hospital,Handan 056001,China)

机构地区：[1]河北省邯郸市中心医院泌尿外科

出　　处：《广西医学》2019年第19期2459-2461,共3页Guangxi Medical Journal

摘　　要：目的探讨肾上腺异时转移癌患者的临床特征及治疗方法。方法回顾性分析12例肾上腺异时转移癌患者的临床资料,结合相关文献总结其临床特征及治疗方法。结果12例患者均为单侧肾上腺异时转移癌,其中左侧5例,右侧7例。原发肿瘤为肺癌者5例(41.67%),肾癌2例(16.67%),肝癌2例(16.67%),胃癌1例(8.33%),结肠癌1例(8.33%),甲状腺癌1例(8.33%)。所有患者均无原发性功能性肾上腺肿瘤的典型临床表现,主要临床表现为腰部酸胀疼痛、消瘦、纳差;肾上腺皮质和髓质功能检查均正常;CT检查提示肿瘤形态呈球形、椭圆形或不规则分叶状,内部密度不均匀,增强扫描可见不均匀强化,瘤内可见钙化、坏死或出血。9例患者采用腹腔镜手术治疗,生存期为(27.1±5.3)个月,3例患者采用保守治疗,生存期为(11.2±3.3)个月。结论肾上腺异时转移癌多无特异性临床症状,影像学检查可提高其检出率,治疗方法的选择应从最有利于患者的角度出发,最大限度地延长患者生存期,提高患者的生存质量。Objective To investigate the clinical characteristics and treatment methods of patients with metachronous adrenal metastases.Methods The clinical data of 12 patients with metachronous adrenal metastases were retrospectively analyzed,and their clinical characteristics and treatment methods were summarized based on the relevant literature.Results All of the 12 cases were unilateral metachronous adrenal metastases,including 5 on the left side and 7 on the right side.Tumors originated from lung cancer were found in five cases(41.67%),renal cancer in two cases(16.67%),liver cancer in two cases(16.67%),gastric cancer in one case(8.33%),colon cancer in one case(8.33%),and thyroid cancer in one case(8.33%).None of the patients presented typical clinical manifestations of primary functional adrenal tumor,and the main clinical manifestations were lumbar distention and pain,marasmus and poor appetite;the functions of adrenal cortex and medulla were normal;CT examination revealed that the tumor was spherical,elliptic or irregularly lobulated with uneven internal density inside,and exhibited heterogeneous enhancement with calcification,necrosis or hemorrhage inside on enhanced scanning.Nine patients were treated with laparoscopic surgery and gained an average survival time of 27.1±5.3 months,and three patients received conservative treatment and gained an average survival time of 11.2±3.3 months.Conclusion Most metachronous adrenal metastases have no specific clinical symptoms,imaging examination is beneficial to improving the detection rate.Treatment methods should be chosen based on the perspective of the best outcome for patients,thus maximizing the survival time and improving the quality of life of patients.

关 键 词：肾上腺异时转移癌 临床表现 诊断 治疗 预后 

分 类 号：R737.11[医药卫生—肿瘤]