转移性肾上腺癌的临床治疗(附15例报告)

目的:分析我院收治的15例肾上腺转移性恶性肿瘤的临床资料,结合文献复习,总结临床诊治体会。方法:回顾性分析我院2011年1月至2019年5月收治的15例肾上腺转移性恶性肿瘤患者的临床资料。男12例,女3例;平均年龄为63岁(53~73岁)。肾上腺转移瘤的最大径中位值为4.4 cm(2.0~9.8 cm),左侧11例,右侧3例,双侧1例。原发恶性肿瘤来源:肺7例,肝3例,肾2例,子宫1例,胰腺1例,腹膜后肿物1例。本研究中15例肾上腺转移恶性肿瘤为原发肿瘤确诊后诊断,距离原发肿瘤诊断的中位时间为15.6个月(5~28个月)。15例患者均行手术切除治疗。结果:术后病理细胞类型:腺癌4例,肝细胞癌3例,透明细胞癌2例,弥漫性大B细胞瘤2例,神经内分泌癌1例,癌肉瘤1例,肺小细胞癌1例,肺大细胞癌1例。术后定期随访患者,15例患者生存4~78个月。患者最终死于肿瘤广泛转移。结论:我院肾上腺转移性恶性肿瘤的原发肿瘤以肺癌最为常见,多数转移瘤在定期复查中无意发现。我院肾上腺转移瘤以左侧多见。肾上腺转移瘤治疗方式有手术治疗、介入治疗、经皮肿瘤消融、免疫治疗、放疗和化疗等。

Clinical treatment of metastatic adrenal carcinoma (report of 15 cases)

Objective: To analyze the clinical data of 15 cases of adrenal metastases treated in our hospital，and to summarize the experience of clinical diagnosis and treatment combined with literature review.Methods:The clinical data of 15 patients with adrenal metastases treated in our hospital from January 2011 to May 2019 were analyzed retrospectively.There were 12 males and 3 females with an average age of 63 years (53~73 years).The median maximum diameter of adrenal metastases was 4.4 cm (2.0~9.8 cm) in 11 cases on the left，3 cases on the right side and 1 case on both sides.The origin of primary malignant tumor was 7 cases of lung，3 cases of liver，2 cases of kidney，1 case of uterus and 1 case of pancreas.There was 1 case of gland and 1 case of retroperitoneal mass.In this study，15 cases of adrenal metastases were diagnosed after diagnosis，and the median time from the diagnosis of primary tumors was 15.6 months (5~28 months).All 15 patients were treated by surgical resection.Results:There were 4 cases of adenocarcinoma，3 cases of hepatocellular carcinoma，2 cases of clear cell carcinoma，2 cases of diffused large B cell tumor，1 case of neuroendocrine carcinoma，1 case of carcinosarcoma，1 case of small cell carcinoma of lung and 1 case of large cell carcinoma of lung.The patients were followed up regularly after operation，and 15 patients survived for 4 to 78 months.The patient eventually died of extensive metastasis of the tumor.Conclusion:Adrenal gland in our hospital lung cancer is the most common primary tumor in metastatic malignant tumors，and most metastases are unwittingly found during regular reexamination.Adrenal metastases are more common on the left side of our hospital.The treatment of adrenal metastases includes surgical treatment，interventional therapy，percutaneous tumor ablation，immunotherapy，radiotherapy and chemotherapy.