基础医学与临床 ›› 2008, Vol. 28 ›› Issue (6): 646-650.

• 临床园地 • 上一篇    下一篇

腹膜后静止型副神经节细胞瘤的临床诊治

文进 李汉忠 石冰冰   

  1. 中国医学科学院 北京协和医学院 北京协和医院 北京协和医院泌尿外科 北京协和医院泌尿外科
  • 收稿日期:2008-03-14 修回日期:2008-04-16 出版日期:2008-06-25 发布日期:2008-06-25
  • 通讯作者: 文进

Diagnosis and treatment of stationary paraganglioma in retroperitoneum

  

  • Received:2008-03-14 Revised:2008-04-16 Online:2008-06-25 Published:2008-06-25

摘要: 目的 提高腹膜后功能静止型副神经节细胞瘤的诊断和治疗水平。 方法 分析1997年至今资料完整、病理证实的功能静止型副神经节细胞瘤10例。术前行内分泌检查、影像学及核医学等检查。4例术前服用2~4周α受体拮抗剂。3例接受腹腔镜手术,7例接受经腹开放手术。结果 功能静止型副神经节细胞瘤患者血压及尿儿茶酚胺通常为正常或稍高,131IMIBG和奥曲肽显像定位准确、敏感性高。4例肿瘤位于肾门旁,6例位于肾下方腹主动脉旁,直径3~15cm。术后病理结果:7例为副神经节细胞瘤,3例为恶性副神经节细胞瘤,免疫组化染色:cgA(+) ,syn(+), NSE(+), s-100(+)。1例恶性副神经节细胞瘤于术后1年发生全身转移。结论  一旦确诊功能静止型副神经节细胞瘤,应该在充分药物准备的基础上,手术切除肿瘤,术后应密切随访。

Abstract: Object To highlight the diagnose and treatment of stationary paraganglioma in retroperitoneum . Methods 10 cases of stationary medullary chromaffinoma of retroperitoneum proven pathologically from 1997 to 2007 were reviewed and sutdied . Hypertension were not observed in all patients , who were admitted to hospital through routine phisical examination . Endocrine secretion examinations , B-US , CT, MRI , 131IMIBG ,and octreotide were used to dianose the diease.Among all 10 patients , 4 cases took α-receptor blocker for 2-4 weeks preoperatively.3 were operated laparoscopically , 7 were operated with lumber incision .Results Hypertension and urinary catecholamine was usually normal or elevated lightly in stationary medullary chromaffinoma of retroperitoneum .131and octreotide have high sensitivity and accuracy in diagosing medullary chromaffinoma . 4 were near renal hilum , 6 was in para-aorta. They were from 3cm to 15cm in size . The results of pathology were paraganglioma in 7 and malignant paraganglioma in 3 . Tumor markers were positive ,such as cgA ,syn, NSE and s-100.There was 1 case metastasis 1 years later .Conclusions Once the correct diagnosis is acquired , surgical treatment should be carry out on the basis of correct drug preparation . Intimate follow-up is necessary and important .