双侧肾上腺嗜铬细胞瘤并腹膜后副神经节瘤1例报告并文献复习

目的:探讨嗜铬细胞瘤及副神经节瘤的诊断和治疗。方法:诊治1例双侧肾上腺嗜铬细胞瘤并腹膜后副神经节瘤的患者。该患者同时患有高血压、Ⅱ型糖尿病,术前血浆及尿游离儿茶酚胺水平明显高于正常,CT检查提示双侧肾上腺富血供占位病变,腹膜后占位病变。结果:术前口服酚苄明降压及充分扩容后,全麻下行开放手术切除右侧肾上腺肿瘤,3个月后腹腔镜下切除左肾上腺肿瘤及腹膜后肿瘤。病理检查诊断为双侧肾上腺嗜铬细胞瘤、腹膜后副神经节瘤。患者术后半月余血糖恢复正常,血压较术前无明显变化,随访6个月无肾上腺皮质功能减退表现,未见肿瘤复发和转移。结论:提高认识、选择适当检查是诊断嗜铬细胞瘤和副神经节瘤的关键,进行充分的术前准备后手术切除肿瘤病灶是其首选治疗方法,术后应严格随访。

Bilateral pheochromocytomas with retroperitoneal paraganglioma. a case report and review of literature

Objective： To investigate the diagnosis and treatment of pheochromocytoma and paraganglioma. Method：One case of bilateral pheoehromocytomas with retroperitoneal paraganglioma was reported. The patient also suffered from hypertension and diabetes, with significant higher plasma and urinary catecholamine levels than normal level. CT scan showed hypervascular bilateral adrenal tumors and retroperitoneal tumor. Result：The right adrenal tumor was removed by opening operation under genera anesthesia with the preoperative oral phenoxy- benzamine and adequate fluid administration. Then the left adrenal and retroperitoneal tumor were resected by lap- aroscopic technique three months later. The pathological diagnosis of the resected specimens was bilateral pheo- chromocytomas with retroperitoneal paraganglioma. The levels of postoperative blood glucose returned to normal condition while the blood pressure levels didn＇t change obviously after operation. No adrenal insufficiency, tumor recurrence or metastasis was observed after six-month follow-up period. Conclusion： Raising awareness of the disease and choosing the suitable examination are the keys to the diagnosis of pheochromocytoma and paraganglioma. Surgical removal of the tumor focus after adequate preoperative preparation is the preferred management and dose follow-up plan after surgery is also needed.