儿童肾上腺皮质癌的临床和CT表现分析  

Analysis of clinical and CT manifestations of adrenocortical carcinoma in children

作　　者：王圆圆[1] 李小会[1] 杨明[1] 高峰[1] 陈桂玲 管红梅[1] 盛会雪 顾海斌 WANG Yuanyuan;LI Xiaohui;YANG Ming;GAO Feng;CHEN Guiling;GUAN Hongmei;SHENG Huixue;GU Haibin(Department of Radiology,Children's Hospital Affiliated to Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院放射科,南京210008

出　　处：《临床肿瘤学杂志》2021年第12期1140-1143,共4页Chinese Clinical Oncology

摘　　要：目的探讨儿童肾上腺皮质癌(ACC)的临床和CT表现特点。方法回顾性分析南京医科大学附属儿童医院2010年9月至2019年12月经手术病理证实的8例ACC患儿的CT影像资料。结果8例肿瘤均为单发病灶,其中男性5例、女性3例,年龄范围5月~11岁9个月;肿瘤位于右侧肾上腺4例,左侧肾上腺4例。临床表现主要为腹部包块、高血压、外周性早熟和皮质醇症。CT平扫显示6例肿瘤呈类圆形、2例呈分叶状,平均直径约9 cm;8例肿瘤均以实性成分为主,3例密度均匀、5例密度不均者伴出血坏死、斑点状或片状钙化灶。增强扫描所有病灶均呈不均匀强化,其中3例病灶呈渐进性强化且边界清晰;5例延迟强化且病灶周围可见渗出、3例病灶内可见分隔样强化;8例病灶内均可见迂曲紊乱的肿瘤血管。结论儿童ACC的CT表现有一定特征性,结合临床表现及实验室检查、病理等结果综合分析,有助于提高对本病的诊断和鉴别诊断能力。Objective To investigate the clinical and CT manifestations of adrenocortical carcinoma(ACC)in children.Methods CT imaging data of 8 children with ACC confirmed by surgery and pathology from September 2010 to December 2019 in the Children's Hospital Affiliated to Nanjing Medical University were retrospectively analyzed.Results All cases of ACC were single lesions,including 5 males and 3 females,aged from 5 months to 11 years and 9 months.The tumors were located in the right adrenal gland in 4 cases and the left adrenal gland in 4 cases.The main clinical manifestations were abdominal mass,hypertension,peripheral precocious puberty and cortisol.Plain CT scan showed lesions were round in 6 cases and lobulated in 2 cases.The average diameter is approximately 9 cm.Eight cases of tumors were mainly solid components including 3 cases of uniform density and 5 cases of uneven density with hemorrhagic necrosis,spot-like or flaky calcification.Contrast-enhanced scan showed heterogeneous enhancement in all lesions,of which 3 cases showed progressive enhancement with clear borders,5 cases with delayed enhancement and exudation around the lesions,and 3 cases with separation enhancement.Tortuous and disordered tumor vessels were seen in all cases.Conclusion CT findings of ACC in children have certain characteristics.It is helpful to improve the ability of diagnosis and differential diagnosis of ACC by analyzing and summarizing the results of clinical manifestations,laboratory examination and pathology.

关 键 词：儿童 肾上腺皮质癌 临床表现 计算机断层扫描 

分 类 号：R736.6[医药卫生—肿瘤]