肾上腺皮质嗜酸性细胞腺瘤的11例诊治分析并复习文献.docVIP

肾上腺皮质嗜酸性细胞腺瘤的11例诊治分析并复习文献 王海明1，邵明明1，陈岐辉1，王晓庆1 *( 【摘要】目的：探讨肾上腺皮质嗜酸性细胞腺瘤(adrenocortical oncocytic adenoma)的临床诊治方法，加深对其认识，提高诊治水平。方法：回顾性分析2010年至2012 年收治的11例肾上腺皮质嗜酸性细胞腺瘤患者的临床资料并复习相关文献总结其临床特征、影像及病理表现、治疗和预后。结果：术前均诊断为肾上腺腺瘤。7 例行后腹腔镜肾上腺腺瘤切除术，4 例行开放性肾上腺肿瘤切除术。送检标本病理诊断均符合肾上腺皮质嗜酸性细胞腺瘤诊断标准。术后恢复顺利，随访至今,患者均无复发或转移。结论：多数肾上腺皮质嗜酸性细胞腺瘤是一种良性肿瘤，预后良好。但部分肿瘤存在恶性潜能Diagnosis and treatment of eleven cases of adrenocortical oncocytic adenoma：report of 11 cases and review the literature bstract Objective: To investigate the diagnosis and surgical treatment of adrenocortical oncocytic adenoma. Methods:The clinical data from 11 cases of adrenocortical oncocytic adenoma were retrospectively analyzed and discussed in light of the relevant literature.Results: The preoperative diagnosis of the patients was adrenal adenomas. Seven patients underwent a retroperitoneal laparoscopic procedure, and 4 patients received an open surgery for the resection of the tumor. All the operation were successfully performed. The pathological diagnosis of tumor was adrenocortical oncocytic adenoma. No recurrence or metastasis was observed after close follow-up observation for 5–30 months.Conclusions: Most of adrenocortical oncocytic adenoma are benign tumors and have favorable prognosis. It was hard to make a confirmed diagnosis of adrenocortical oncocytic adenoma on clinical symptoms and imaging features before surgery. Reports in the literature are not sure malignant potential, and close follow-up observation is essential. KEY WORDS：adrenal tumor；adrenocortical oncocytoma；iagnosis; treatment. 肾上腺皮质嗜酸细胞腺瘤是一种极其罕见的肾上腺良性肿瘤, 自1986年Kakimoto等首次报道肾上腺皮质嗜酸细胞腺瘤以来[1]，国内外文献报道不足200例[2-5]。对其诊断标准和生物学行为的判定仍未达成共识，大多为偶然体检发现,但其诊治及鉴别仍有困难。2010年1月至2012年9月吉林大学第一医院泌尿外科共收治11例肾上腺皮质嗜酸细胞腺瘤患者。本研究对本病的临床、病理特点及诊断治疗方式进行总结,结果报道如下。 1 临床资料 本组11例。男5例, 女6例。年龄6-58岁。病史2周～7年，病变均发生于单侧肾上腺，其中左侧4例，右侧7例。体检发现肾上腺区肿块5例；以腰肋部疼痛为主要症状2例；女性男性化1例,主要表现为体毛重、皮肤粗糙及月经不调；库欣综合征表现2例,表现为高血压、满月脸，悬垂腹、向心性肥胖，下腹部皮肤紫纹等；单纯表现为高血压者2例。除2例以库欣综合征为临床表现的患者外，余患者体检均未见异常。术前血常规、血生化等检查均无异常，除2例库欣综合征表现