肾上腺外嗜铬细胞瘤的诊断与治疗体会(附4例报告)

目的 探讨肾上腺外嗜铬细胞瘤的诊断和手术治疗体会。方法 回顾性分析4例不同部位的肾上腺外嗜铬细胞瘤的诊断和治疗经过。结果 本组均以高血压为主要临床表现。肿瘤位于腹主动脉旁1例，左上纵隔内1例，左侧腰椎旁1例，膀胱内及两侧髂内血管旁多发肿瘤1例，其中恶性嗜铬细胞瘤1例。均手术切除肿瘤，无手术并发症。结论 肾上腺外嗜铬细胞瘤临床表现和生化诊断与肾上腺嗜铬细胞瘤相似，但定位诊断较困难。定位诊断主要依靠超声、CT扫描及磁共振检查，配合同位素间碘变甲胍(^131I-MIGB)和血管造影。外科手术是最好的治疗手段。

Diagnosis and treatment of extra-adrenal pheochromocytoma( a report of 4 cases)

Objective To investigate the experience in the diagnosis and treatment of extra-adrenal pheochromocytoma. Methods Clinical data of diagnosis and treatment in 4 cases of extra-adrenal pheochromocytoma were analyzed retrospectively. Results All the cases showed hypertension. There were 1 case with tumor at para-abdominal aorta, 1 case in left superior mediastinum, 1 case by lumbar verbras, 1 case with multiple tumors in bladder and by both internal iliac vessels. The tumor in one case was malignant confirmed by pathology. Total resection of tumor was performed in all cases with no operative complications. Conclusion Clinical manifestations and biochemical findings of extra-adrenal pheochromocytoma were similar to that of adrenal pheochromocytoma. The localization resorts to ultrasonography, CT and MRI in combination with I 131-MIGB and angiography. Tumor resection is the first choice of extra-adrenal pheochromocytoma.