肾上腺偶发瘤治疗的临床研究

目的 探讨肾上腺偶发瘤治疗方法.方法 回顾性分析1996年1月至2006年1月156例肾上腺偶发瘤患者的临床资料及随访结果.结果 156例患者中1例因多器官转移行放疗、化疗,4例肿瘤较小者随诊观察,151例接受手术治疗.肿瘤直径1.3～15.0 cm.病理结果提示嗜铬细胞瘤34例,皮质腺瘤83例,皮质癌5例,转移癌3例,肾上腺囊肿等其他良性肿瘤26例.随访136例,随访时间1～7年,3例转移癌患者1.5年内均死亡;随访到的2例皮质癌患者分别于术后2.0、2.5年死于复发、转移.余131例均健康存活,其中3例口服地塞米松至术后1年.结论 恶性肿瘤、有功能肿瘤、亚临床型肾上腺皮质肿瘤、嗜铬细胞瘤、直径大于3cm的肿瘤应手术治疗;而小于3cm的无功能肿瘤可定期严密随访.

Clinical research about treatment for adrenal incidentalomas

Objective To explore the therapeutic methods of adrenal incidentalomas.Methods The data of 156 cases were analyzed retrospectively.Results The operation were performed in 151 cases,radiotherapy and chemotherapy in 1 case and follow up in 4 cases.The diameter of the tumors were 1.3-15.0cm. Pathological results indicared that 34 cases were pheochromocytoma,83 adrenal cortical adenoma,5adrenal cortical carcinoma,3 metastases carcinoma,and 26 other benign tumors.One hundred and thirty-six cases were followed-up for 1-7 years.3 cases of metastases carcinoma died in 1.5 years,2 cases of cortical carcinoma died in 2.0 and 2.5 years for recurrence and metastases.One hundred and thirty-one cases survived healthly,3 cases of them take orally Corson for 1 year after post-operation.Conclusions Surgical operations should be performed in malignant tumors.hypersecretional tumors,deuto-clinical adrenal cortical tumors,pheochromocytoma and those whose diameters of tumors are over 3 cm.But those whose tumors had nonhypersecretions and diameters are less than 3 cm should be followed up closely.