CAJ | 학술논문

目的：提高肾上腺偶发瘤( AI)的诊断与鉴别诊断水平,指导临床治疗。方法回顾性分析我院2005年1月至2011年12月因健康体检或肾上腺疾病以外原因就诊发现的86例肾上腺偶发瘤患者的临床资料,并复习国内外相关文献。结果86例AI患者中84例(97．7%)接受手术治疗,后腹腔镜手术55例(64．0%),其中4例中转开放手术,有内分泌功能肿瘤37例(43．0%),术后病检确诊皮质腺瘤40例,嗜铬细胞瘤24例,髓性脂肪瘤8例,囊肿5例,皮质腺癌2例,肾上腺皮质结节样增生2例,转移性肿瘤1例,血管平滑肌脂肪瘤1例,神经节细胞瘤1例。81例良性肿瘤随访1~6年未见复发,3例转移性肿瘤均在2年内死于原发肿瘤,2例皮质腺癌中1例术后11个月死于广泛转移,1例随访2年3个月仍存活。结论影像学检查结合内分泌检测有助于AI的定位及定性诊断,明确诊断的<3cm的肾上腺囊肿、血肿及髓性脂肪瘤可随访观察除外,其余AI均应积极手术,腹腔镜手术是AI的首选术式。
목적：제고신상선우발류( AI)적진단여감별진단수평,지도림상치료。방법회고성분석아원2005년1월지2011년12월인건강체검혹신상선질병이외원인취진발현적86례신상선우발류환자적림상자료,병복습국내외상관문헌。결과86례AI환자중84례(97．7%)접수수술치료,후복강경수술55례(64．0%),기중4례중전개방수술,유내분비공능종류37례(43．0%),술후병검학진피질선류40례,기락세포류24례,수성지방류8례,낭종5례,피질선암2례,신상선피질결절양증생2례,전이성종류1례,혈관평활기지방류1례,신경절세포류1례。81례량성종류수방1~6년미견복발,3례전이성종류균재2년내사우원발종류,2례피질선암중1례술후11개월사우엄범전이,1례수방2년3개월잉존활。결론영상학검사결합내분비검측유조우AI적정위급정성진단,명학진단적<3cm적신상선낭종、혈종급수성지방류가수방관찰제외,기여AI균응적겁수술,복강경수술시AI적수선술식。
Objective To improve diagnosis and differential diagnosis of adrenal incidentoloma to guide clinical therapy. Methods The clinical data of 86 cases of adrenal incidentoloma from January of 2005 to December of 2011 were retrospectively analysed,relative papers were also reviewed. Results 84 cases received operation,55 cases received retmperitoneal laparoscopic surgery,37 cases were tumors with secretary function,post operative pathology finally diagnosed adrenalcortical adenoma in 40 ca-ses,pheochromocytoma in 24 cases,myelolipoma in 8cases,cyst in 5 cases,adrenalcortical carcinoma and adrenal nodular hyperpla-sia in 2 cases,metastatic tumor,angioleiomyolipoma and paragangliloma in 1 case. All benign tumors were followed up 1-6 years without recurrence,metastatic tumors died in 2 years,one of adrenalcortical carcinoma died 11 months after operation,the other still survived 2 years and 3 months after operation. Conclusion Imaging examinations and laboratory tests are beneficial to diagnosis, AI cases should receive surgery positively except cyst,myelolipoma and hematoma less than 3cm in diameter, laparoscopic surgery can be first choice of operation.