肾上腺转移癌(附11例报告)  

Metastatic adrenal carcinoma(report of 11 cases)

作　　者：杨金校[1] 孙颖浩[1] 王林辉[1] 杨波[1] 高小峰[1] 张世林[1] 

机构地区：[1]上海第二军医大学长海医院泌尿外科

出　　处：《中华泌尿外科杂志》2004年第5期293-295,共3页Chinese Journal of Urology

摘　　要：目的　探讨肾上腺转移癌的临床特点与诊治方法。　方法　回顾分析 1993年 12月至2 0 0 3年 3月肾上腺转移癌患者 11例的诊治结果。原发灶为肺癌 4例 ,肝癌 5例 ,胆管癌 1例 ,肾癌 1例。临床表现腰背部胀痛 3例 ,乏力、消瘦 3例 ,血尿 1例 ,无症状者 4例。 11例行B超及CT检查 ,2例行正电子发射断层扫描 (PET)检查。 11例均行手术治疗 ,肿瘤完整切除 9例 ,姑息性切除 1例 ,双侧转移者仅行左侧切除 1例。　结果　完整切除转移癌 9例中 5例生存 6～ 6 3个月 ,平均 34个月 ;2例已分别存活 2及 16个月 ,仍在随访中 ;2例失访。 1例行姑息性切除者生存 3个月 ,1例双侧肾上腺转移癌仅行左侧切除者生存 4个月。　结论　B超及CT是诊断肾上腺转移癌的重要检查方法 ,PET对诊断肾上腺转移癌有较高的临床价值。手术切除转移灶是延长患者生存期的最有效方法。Objective To evaluate the clinical features,diagnosis and treatment of metastatic adrenal carcinoma. Methods The data of 11 cases of metastatic adrenal carcinoma who were admitted from December 1993 to March 2003 were reviewed,including 4 cases of lung carcinoma,5 cases of hepatocellular carcinoma,1 case of bile duct carcinoma and 1 case of renal cell carcinoma.The main clinical manifestations were waist pain in 3,fatigue and weight loss in 3,hematuria in 1 and no symptom in 4.All the 11 cases underwent B-ultrasonography and CT scan,of whom 2 underwent positron emission tomography (PET).All patients were treated by surgical operation,including 9 cases by total adrenalectomy,1 case by palliative adrenalectomy and 1 bilateral metastatic case by left-adrenalectomy alone. Results In 5 cases by total adrenalectomy the survival time was 6 to 63 months with a mean of 34 months.Two cases were followed up for 2 to 16 months and 2 cases were lost with follow-up.One case by palliative adrenalectomy survived for 3 months.One bilateral metastatic case by left-adrenalectomy survived for 4 months. Conclusions Ultrasonography and CT are important in the diagnosis of metastatic adrenal carcinoma,and PET is of greater value in clinical practice.Complete adrenalectomy may be the best treatment choice to prolong the survival time.

关 键 词：肾上腺转移癌 临床特点 影像学诊断 原发病 

分 类 号：R736.6[医药卫生—肿瘤]