基础医学与临床 ›› 2017, Vol. 37 ›› Issue (9): 1313-1316.

• 疑难病例 • 上一篇    下一篇

巨大肾上腺肿瘤2例诊治分析

邢绍强,董礼明,张学峰,孙长海   

  1. 威海市中心医院
  • 收稿日期:2016-09-27 修回日期:2017-03-24 出版日期:2017-09-05 发布日期:2017-08-28
  • 通讯作者: 邢绍强 E-mail:xingshaoqiang828@163.com

Analysis of two cases for huge adrenal tumor

  • Received:2016-09-27 Revised:2017-03-24 Online:2017-09-05 Published:2017-08-28
  • Contact: Shao-Qiang XING E-mail:xingshaoqiang828@163.com

摘要: 目的 探讨肾上腺巨大肿瘤的临床表现及诊治方法。方法 回顾性分析2013年9月至2015年1月威海市中心医院收治的2例肾上腺肿瘤直径超过10 cm的患者的相关资料,对其临床表现、诊治方法及预后进行分析,并查阅国内外文献资料。结果 两例患者术前均疑诊为肾上腺皮质癌。病例1:女性,28岁,行腹腔镜左肾上腺肿瘤切除术,因术中肿瘤破裂、出血而中转开放手术姑息性切除肿瘤,术后病例示肾上腺皮质癌,术后10个月患者死于肿瘤转移导致的消化道大出血;病例2:女性,39岁,行腹腔镜左肾上腺肿瘤切除术,术中完整切除肿瘤,术后病理示具有恶性潜能的肾上腺皮质肿瘤,术后随访15月,未见肿瘤复发。结论 对于直径大于10 cm的肾上腺肿瘤,如果术前诊断倾向于恶性肿瘤,则手术方式宜选择开放术式;巨大肾上腺皮质癌治疗效果较差,应采取手术、化疗等相结合的综合治疗以改善预后。

关键词: 肾上腺肿瘤, 巨大, 肾上腺皮质癌

Abstract: Objective To investigate the clinicopathological characteristics, diagnosis and treatment of huge adrenal tumor. Methods Retrospectively analysed the clinical data of the 2 patients with huge adrenal tumor more than 10 cm in diameter, who were admitted in our hospital from September 2013 to January 2015. Clinical manifestations, treatment methods and prognosis were analyzed. Results Two patients were both suspected of adrenocortical carcinomas. Case 1 was a 28-year-old female. Laparoscopic surgery was performed at first but was conversed to open palliative adrenalectomy due to tumor rupture and bleeding. The postoperative pathology was adrenocortical carcinoma. The patient died of gastrointestinal bleeding caused by tumor metastasis 10 months later. Case 2 was a 39-year-old female, who underwent laparoscopic adrenolectomy with tumor excision completely. The postoperative pathology showed neoplasm of malignant potential, and no tumor recurred during 15 months follow-up. Conclusions Open surgery should be priority if the diameter of adrenal tumor is more than 10 cm and diagnosis as suspicious of malignancy.huge adrenocortical carcinoma shows poor therapeutic effects,and multimodality therapy may improve the prognosis.

Key words: adrenal tumor, huge, adrenocortical carcinoma

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