儿童嗜铬细胞瘤18例诊治分析

目的：对18例儿童嗜铬细胞瘤的诊治进行回顾性分析。以提高诊断和治疗水平。方法：分析18例患儿的临床表现。化验室检查及经腹膜后充气造影，B超，电子计算机体层扫描（CT），磁共振成像（MRI）检查定位诊断。结果：18例主要临床表现有剧烈头痛，心慌，多汗和视物模糊等，症状凶险，血压波动大，常有恶性高血压发作，香草苦杏仁酸（VMA）增高16例（16/18例），血和尿儿茶酚胺增高12例（12/13例），18例均经手术治疗，切除肿瘤19个，肿瘤重达40-150g。术后随访1-20年，血压恢复正常17例，占94?7/18例），1例2年后肿瘤复发，诊断为恶性嗜铬细胞瘤，第3年死亡，结论：儿童嗜铬细胞瘤临床少见，与成人相比表现不典型，常伴心脏损害。对儿童高血压患者应考虑到有本病的存在，并进行相应检查。争取早期确诊。

The Diagnosis and Treatment for Pheochromocytoma with 18 Cases in Children

Objective:To promote the skill of diagnosis and treatment in children with pheochromocytoma.Methods:Eighteen cases with pheochromocytoma in children diagnosed,treated,laboratory examination, B ultrasonography,CT and MRI were retrospectively analyzed.Results:The main symptom included severe headache,loss of vision,excessive perspiration,and impetuous hypertension.The positive test in urine VMA and chatecholamina was 94 %(16/18),92.3 %(12/13)respectively.Eighteen cases were treated surgery with good care of perioperation, and 19 pheochromocytoma(comfired by pathology)were extirpated.The patients were followed up 1 to 20 years,with 17 cases having normal blood pressure.Only 1 case recurrence of malignancy 3 years later.Conclusion:The clinical manifestations of pheochromocytoma in children are variant but the result of pheochromocytoma in children is better than in adults.