肾上腺转移癌的诊治

目的 总结肾上腺转移癌的临床特点与诊治体会.方法 回顾性分析1996年12月至2010年4月收治47例肾上腺转移癌患者资料.男32例,女15例.平均年龄54(36～70)岁.单侧肾上腺转移42例,其中左侧25例、右侧17例,双侧5例.原发肿瘤包括肺癌24例、肾癌6例、肝癌5例、乳腺癌4例、黑色素瘤2例,其他肿瘤6例.临床表现全身乏力、消瘦、贫血或低热17例,患侧腰背部胀痛9例,高血压6例.均经B超、CT、MRI及正电子发射断层扫描(PET)检查确诊.行手术治疗36例,放弃手术11例.结果 完整切除转移癌者31例获随访,生存2～62(33.8±4.5)个月,最长存活64个月;失访5例.11例放弃手术者6例获随访,生存4～8(6.3±2.7)个月,均死于肿瘤晚期或多发转移.结论 B超及CT检查是诊断肾上腺转移癌的重要方法,PET有较高的临床诊断价值.手术完整切除肾上腺转移灶可延长患者生存期,但需严格控制适应证.

Metastatic adrenal carcinoma

Objective To discuss the diagnosis and management of metastatic adrenal carcinoma. Methods Forty-seven cases with metastatic tumor in the adrenal glands were analyzed retrospectively from December 1996 to April 2010. Lung was the most common primary tumor site (51.1 %, 24 cases), followed by the renal cell carcinoma (12.8%, 6 cases), liver cancer (10.6%,5 cases), breast cancer (8.5%, 4 cases), melanoma (4.2%, 2 cases), and other carcinoma (12.8%,6 cases). Most patients with metastatic adrenal carcinoma had no special clinic manifestation. Lesions of 36 cases were surgically removed and 11 cases gave up operation. Results The mean survival time were 33.8±4.5 months for 31 cases underwent adrenalectomy and 6.3±2.7 months for 6 cases without operation. Patients with surgically removed adrenal metastases had better survival than those without surgical resection. Conclusions Adrenal gland is a common site of metastatic carcinoma.Ultrasonographic and CT scans are important diagnosis methods for metastatic adrenal carcinoma. Operation is still effective and long-term survival may be achieved for those well selected patients, but surgical indication must be strictly monitored.