无功能性肾上腺恶性肿瘤(附12例报告)  

Nonfunctional malignant adrenal tumor(report of 12 cases)

作　　者：李强[1] 张佐良[1] 瞿连喜[1] 吴忠[1] 丁强[1] 张元芳[1] 

机构地区：[1]复旦大学华山医院泌尿外科,上海200040

出　　处：《中华泌尿外科杂志》2003年第9期597-599,共3页Chinese Journal of Urology

摘　　要：目的　探讨无功能性肾上腺恶性肿瘤的临床特点及诊治方法。　方法　无功能性肾上腺恶性肿瘤 12例。其中 6例有发热、骨痛等症状。肿瘤直径 3cm 1例 ,5～ 10cm 9例 ,>10cm 2例。有局部浸润和 (或 )转移者 10例。　结果　 5例行肿瘤切除或剜除 ,5例仅行活检 ,病理诊断皮质腺癌4例 ,转移癌 4例 ,黏液脂肪肉瘤 1例 ,淋巴瘤 1例 ;2例未手术。住院期间死亡 1例 ,2年内死亡 10例 ,1例肾上腺皮质癌于术后 3年复发 ,次年死亡。　结论　无功能性肾上腺恶性肿瘤少见 ,早期诊断困难 ,预后差。Objective To review the clinical features,diagnosis,management and prognosis of patients with nonfunctional malignant adrenal tumors. Methods 12 patients admitted with nonfunctional malignant adrenal tumors from 1990 to 2000 were reviewed.Among them 6 cases had symptoms of fever,ostealgia,etc.The tumor measured 3 cm in 1 case,5 to 10 cm in 9 cases and more than 10 cm in 2 cases.Ten cases developed local invasion and (or) matastasis. Results Five cases underwent tumor excision or enucleation and 5 underwent biopsy only.Of these 10 cases,4 were pathologically diagnosed as cortical adenocarcinoma,4 as metastatic carcinoma,1 as mucous liposarcoma and 1 as lymphoma.The remaining 2 cases had no operation.One case died during hospital stay.Ten cases died within 2 years.One case of adrenocortical carcinoma experienced relapse 3 years after initial operation and died next year. Conclusions Nonfunctional malignant adrenal tumor is rare and difficult to diagnosis in early stage,indicating an extremely poor prognosis.Tumor diameter is an important factor to be considered regarding surgical indication.

关 键 词：无功能性肾上腺恶性肿瘤 临床表现 手术治疗 预后 

分 类 号：R736.6[医药卫生—肿瘤]