肾上腺偶发瘤44例诊断和治疗

目的 提高对肾上腺偶发瘤的诊治水平。方法 回顾性总结44例肾上腺偶发瘤的临床资料，复习相关文献。结果 39例经手术治疗。效果满意。病理检查发现皮质腺瘤21例，嗜铬细胞瘤9例，肾上腺囊肿4例，皮质腺癌2例，混合瘤、平滑肌瘤及神经节细胞瘤各1例。5例不愿手术患者门诊随访。结论 在健康体检时应常规作肾上腺B超检查，CT、MRI对确诊肾上腺占位病变有较高价值。恶性肿瘤、肿瘤直径≥3．0cm者和随诊中肿瘤有增大趋势者应早期手术治疗；腹腔镜肾上腺外科手术可能成为肾上腺偶发瘤的首选治疗方法。

Diagnosis and Treatment of Adrenal Incidentaloma:Report of 44 cases

Objectives To evaluate the methods of diagnosis and treatment of adrenal incidentaloma. Methods The clinical data of 44 cases with adrenal incidentaloma were analyzed retrospectively. Results The effect of operative treatment on 39 cases with adrenal incidentalomas is satisfactory. By pathological examination, 21 of them were diagnosed as adrenocortical adenoma, 9 pheochromocytomn, 4 adrenal cyst, and 1 mixed cell adenoma, 1 leiomyima, 2 adrenocortial carcinoma, and 1 gangliocytoma. Conclusions B type ultrasonography of the adrenals should be performed routinely in health examination. Tumors smaller than 3.0cm might be followed-up with B type ultrasonography and CT scanning yearly. Malignant tumors or tumors larger than 3.0cm in diameter should be treated by operation earlier. Laparoscopic adrenalectomy will be the first choice for adrenal incidentaloma