无功能性肾上腺肿瘤的诊断与治疗(附39例报告)

目的：提高无功能性肾上腺肿瘤的诊治水平。方法：回顾性分析我院17年来39例无功能性肾上腺肿瘤患者的临床资料。结果：39例中，38例行肿瘤切除或剜除术，1例仅行活组织检查；30例病理检查证实为良性无功能性肾上腺肿瘤，其中节细胞神经瘤7例，平滑肌瘤1例，皮质腺瘤10例，髓脂瘤3例，神经鞘瘤1例．肾上腺囊肿8例。随访6个月～7年，临床症状消失，无肿瘤复发。9例病理检查证实为恶性无功能性肾上腺肿瘤，其中脂肪肉瘤1例，皮质腺癌4例，转移癌4例，术后2年内，8例死亡，1例无癌生存14个月。结论：无功能性肾上腺肿瘤临床少见，早期诊断困难，CT是首选检查方法，确诊依赖于病理检查。手术切除是良性肿瘤的有效手段，但对恶性肿瘤预后较差。

Diagnosis and therapeutics of nonfunctional adrenal tumor (Report of 39 cases)

Objective:To improve the diagnosis and treatment for nonfunctional adrenal tumor.Methods:39 patients admitted with nonfunctional adrenal tumors in the past 17 years were reviewed.Results:38 patients underwent tumor excision or enucleation and 1 underwent biopsy only. Of the 39 cases, 30 cases of benign nonfunctional adrenal tumors were pathologically diagnosed as 7 ganglioneuroma, 1 leiomyoma, 10 cortex neoplasms, 3 myelolipoma, 1 neurilemmoma; and 8 cyst. the patients have been asympotomatic on following-up for 0.5~7 years and there is no recurrence of tumor. 9 cases of nonfunctional malignant adrenal tumor were pathologically diagnosed as 1 liposarcoma, 4 cortical adenocarcinoma and 4 metastatic carcinoma.;8 cases died within 2 years, 1 case had been no recurrence of tumor for 14 months.Conclusions:Nonfunctional adrenal tumor is rare and difficult to diagnose in early stage, computed tomography (CT)should be the first study done; Definite diagnosis depends on pathological studies. Tumor resection is the treatment of choice with good prognosis for benign tumors, but malignant ones have poor prognosis.