膀胱嗜铬细胞瘤的诊断和治疗

目的了解膀胱嗜铬细胞瘤患者诊治情况,提高膀胱嗜铬细胞瘤的诊断和治疗水平.方法对5例膀胱嗜铬细胞癌的临床资料进行回顾性分析.4例行膀胱部分切除术,1例行膀胱全切除术.结果术前确诊4例,术后5例均经病理证实为膀胱嗜铬细胞瘤.随访10个月～12 a,1例术后16个月转移,死于脑出血,其他4例血压正常,无肿瘤复发.结论血尿、高血压、排尿时典型发作三联征为膀胱嗜铬细胞瘤的主要症状.B超、CT、MRI、131I-MIBG作定位诊断,尿4-羟-3甲氧扁桃酸(VMA)和尿儿茶酚胺作定性诊断.手术切除是最有效的治疗方法,术后密切监测尿儿茶酚胺含量,可以了解有无转移和复发.

Diagnosis and Treatment of Pheochromocytoma in Urinary Bladder

[Objective] To improve the diagnosis and treatment of pheochromocytoma in urinary bladder.[Methods] Retrospective analysis was made on the clinical data of 5 cases of pheochromocytoma in urinary bladder.4 cases underwent partial cystectomy,and 1 case underwent total cystectomy.[Results] 4 cases were confirmed pheochromocytoma in urinary bladder before operation,the other one was confirmed after operation through pathological analysis.The 10 months to 12 years' follow-up showed that 1 case suffered from tumor metastasis and died from cerebral hemorrhage 16 month after operation,other 4 cases underwent no tumor recurrence with normal blood pressure.[Conclusion]The typical symptoms of bladder pheochromocytoma are hematuria,hypertension and paroxysmal occurrence during micturition.Cystectomy is proved to be the most effective treating method.Urinary catecholamine should be carefully observed after operation to monitor the recurrence and metastasis of tumor.