基础医学与临床 ›› 2014, Vol. 34 ›› Issue (2): 240-243.

• 临床园地 • 上一篇    下一篇

功能静止型嗜铬细胞瘤29例临床分析

周智恩1,李汉忠2,石冰冰3   

  1. 1. 中国医学科学院北京协和医院泌尿外科
    2. 中国医学科学院北京协和医学院北京协和医院泌尿外科
    3. 中国医学科学院 北京协和医学院 北京协和医院
  • 收稿日期:2013-07-04 修回日期:2013-10-08 出版日期:2014-02-05 发布日期:2014-01-13
  • 通讯作者: 李汉忠 E-mail:lihanzhong@medmail.com.cn

A retrospective clinical study of clinically silent pheochromocytoma in 29 cases

Zhi-en ZHOU,1,LI Han-zhong Bing-bing SHI   

  • Received:2013-07-04 Revised:2013-10-08 Online:2014-02-05 Published:2014-01-13
  • Contact: LI Han-zhong E-mail:lihanzhong@medmail.com.cn

摘要: 目的 回顾性分析29例功能静止型嗜铬细胞瘤的临床资料,以提高其诊治水平。 方法 分析2010年5月至2013年5月在北京协和医院接受手术并经病理证实的功能静止型嗜铬细胞瘤患者29例,总结患者年龄、肿瘤部位、肿瘤最大径、手术方式、术中血压变化、尿儿茶酚胺以及术前核医学检查等方面的临床特点。结果 患者血压正常,尿儿茶酚胺正常或稍高,肿瘤位于双侧肾上腺1例,右侧肾上腺13例,左侧肾上腺15例,直径1.5~14cm。腹腔镜手术切除25例,开放手术切除4例。23例术前接受药物准备,术中血压平稳,6例术前未行药物准备,其中2例术中出现血压剧烈波动。23例术前行生长抑素受体显像的患者中,有11例未见异常;11例术前行131IMIBG显像,1例未见异常。结论 对于功能静止型嗜铬细胞瘤,尿儿茶酚胺及生长抑素受体显像敏感性较低,对于CT表现可疑的,建议术前行131IMIBG显像,一旦确诊,应该在充分药物准备的基础上接受手术治疗。

关键词: 功能静止型, 嗜铬细胞瘤

Abstract: Objective To retrospectively analyze the clinical data of clinically silent pheochromocytoma in 29 cases in order to improve its diagnosis and treatment. Methods 29 patients were diagnosed pathologically as adrenal pheochromocytoma from May 2010 to May 2013, who were considered clinically silent and operated in Peking Union Medical College Hospital. We summarized the aspects include patient age, tumor location and maximal diameter, operation method, change of intraoperative blood pressure(BP), urinary catecholamine and the nuclear medicine examinations. Results Each of the 29 patients had a normal BP, and the results of urinary catecholamine were normal or elevated lightly. The maximal diameter of tumors were 1.5~14cm. 1 case was located in both side, while 13 cases in the right and 15 cases in the left. 25 were operated laparoscopically, and the other 4 underwent open operations. BP was stable in all the 23 cases who were given cardula, while 2 of 6 cases who were not given cardula had hypertensive crisis. 11/23 cases had false negative results in somatostatin receptor imaging, while 1/11 cases had a false negative result in 131IMIBG imaging. Conclusions Urinary catecholamine and somatostatin receptor imaging are not sensitive to clinically silent pheochromocytoma. 131IMIBG imaging is necessary to the cases who are highly suspicious in CT imaging. Surgical treatment should be carried out on the basis of correct drug preparation once the correct diagnosis is made.

Key words: clinically silent, pheochromocytoma

中图分类号: