肾上腺皮质癌的诊断与治疗

目的探讨肾上腺皮质癌的诊断和治疗。方法回顾性分析1978年～2000年收治的19例肾上腺皮质癌病人的临床表现、影像学检查、治疗方法及随访资料。结果19例中有内分泌功能紊乱10例，主要以柯兴综合征为主，性征异常及原发性醛固酮增多症相对少见。无内分泌功能9例，主要为急性腹痛、高血压、腰背痛等腺外表现。15例行根治性手术切除，6例于术后8个月～10年复发。4例肿瘤未能切除仅取活检。随访3例均于1年内死亡。结论尿17-羟、17-酮和血、尿皮质醇、醛固酮的测定及CT和B超检查均有助于诊断。手术是唯一有效的治疗方法。早期诊断困难，预后差。

Diagnosis and treatment of adrenocortlcal carcinoma.

Objective To study the methods of diagnosis and treatment of adrenocortical carcinoma-Methods 19 cases of adrenocoraical carcinoma(10 functional and 9 nonfunctional) were reviewed retrospectively. Results The functional carcinoma mainly showed cushing's syndrome. The nonfunctional had extra adrenal symptoms such as acute abdominal pain and hypertension. 15 cases received radical adrenolectomy,6 of which re-currenced 8 months to 10 years after the primary operation.The others received biopsy,3 of which didn't survive one year. Conclusions It is useful for diagnosis by the measurements of urine 17-ketosteroid, 17-hydros-tcroid. cortisol, aldosterone, CT scan, and B ultrasonography. Surgical removal of the tumor is the only effective treatment. Early diagnosis of adrenal cortical carcinoma is very difficult. It has a poor prognosis.