小儿肾上腺皮质癌的超声表现(附16例报告)

目的:分析小儿肾上腺皮质癌(ACC)的超声表现特点并结合特征性的临床表现,作出正确的术前超声诊断。方法:回顾性分析经手术切除,病理证实的16例小儿ACC的超声图像特点及临床表现。结果:超声示肿瘤边界清晰,13例呈低回声为主,其中伴有强回声光点或光团6例。2例高回声,1例中等回声。6例瘤内可见不同程度的囊变。15例肿瘤均未包饶血管,仅1例因瘤体巨大而与腹腔动脉(CA)及肠系膜上动脉(SMA)关系密切。1例肿瘤侵犯肾脏。1例肝转移。左肾静脉或下腔静脉(IVC)或右房形成瘤栓4例。无功能4例,无临床表现。有功能12例,表现有库兴综合征,性征异常,血压升高。结论:小儿功能性ACC多以低回声为主,少数伴有瘤栓,并有特征性的临床表现,诊断并不困难。无功能ACC瘤体多较大,回声不均,无特征性,诊断较困难,需与小儿最多见的神经源性肿瘤鉴别。

Ultrasonic features of adrenocortical carcinoma in children

Objective: To analyze the ultrasonographic features and clinical presentations of adrenocortical carcinoma(ACC) in children. Methods: The ultrasonographic features of ACC in 16 cases were reviewed retrospectively. Results: The margins of tumors were well defined, 13 cases were hypoechoic with hyperechoic areas in 6 cases, 2 cases were hyperechoic, 1 case was medium echoic. The tumors had various level of cystic areas in 6 cases. The tumor extended into vessel or right atrium in 4 cases. Four cases had nonfunctioning ACC without clinical presentations. The clinical aspects included Cushing's syndrome, virilization, hypertension. Conclusion: The tumor was hypoechoic and had tumor-embolism in some cases. It is not difficult to make correct diagnosis at the support of clinical aspects. Nonfunctioning ACC is large, but its ultrasonography had few feature, and the patient had no clinical presentations, so it is difficult to make correct diagnosis. It is necessary to discriminate with neurogenic tumor.