膀胱嗜铬细胞瘤1例诊治并文献复习

目的 探讨膀胱嗜铬细胞瘤的诊治方法.方法 回顾性分析安庆市立医院泌尿外科2014年11月诊治的1例膀胱嗜铬细胞瘤患者的临床资料.结果 患者因"体检镜下血尿1月余"入院,泌尿系B超、盆腔CT及MRI示膀胱前顶壁占位灶.于全麻下行膀胱肿瘤电切术,电切除部分肿物时,血压急剧升高至225/114 mmHg,考虑为嗜铬细胞瘤,改行膀胱部分切除;肿物切除时,患者术中血压一度下降至90/60 mmHg.术中、术后按嗜铬细胞瘤处理,痊愈出院.手术标本经病理及免疫组化证实为膀胱嗜铬细胞瘤.随访30个月,患者血压正常.结论 膀胱嗜铬细胞瘤临床罕见,典型症状为血尿、排尿时头晕、心慌、血压升高,甚至晕厥,可借助B超、CT、MRI定位诊断,手术切除是首选治疗方法,术后应密切随访.

Diagnosis and treatment of pheochromocytoma in urinary bladder (One case report and literature re-view)

Objective To improve the diagnosis and the treatment of pheochromocytoma in u-rinary bladder. Methods The patient treated in November 2014 was included. Results Microhe-maturia was found in the prior month,and the positive mass was found by B-ultrasound,CT and MRI examination during hospitalization in this case.TURBT was performed under general anesthe-sia.However,blood pressure increased sharply to 225/114 mmHg during the procedure,then partial prostatectomy was performed.During the procedure of tumor resection,blood pressure dropped to 90/60 mmHg.Pheochromocytoma was confirmed postoperatively by histologic appearance.Blood pressure was normal after 30 months followed-up period. Conclusions The typical symptoms of bladder pheochromocytoma were hematuria,paroxysmal dizziness,palpitation and hypertension dur-ing micturition.B-ultrasound,CT,MRI have higher diagnostic value in localizing the lesions.Surgi-cal excision of the tumor is the preferred management and a close follow-up plan is needed after sur-gery.