Honda M, Uesugi K, Yamazaki H, Dezawa A, Mizuguchi K, Yamaji T, Ishibashi M
Fourth Department of Medicine, Teikyo University School of Medicine, Kawasaki, Kanagawa.
Intern Med. 2000 Oct;39(10):820-5. doi: 10.2169/internalmedicine.39.820.
A malignant pheochromocytoma is described in a 71-year-old man. Osseous metastases became manifest 12 years after successful removal of the primary tumor which originated in paraganglionic tissue near the right adrenal gland. Although the patient had no symptoms of catecholamine excess initially, hypertension, tachycardia and excessive sweating appeared several months before his death, concomitantly with a sharp increase in noradrenaline secretion due to an accelerated growth of metastatic tumors. Since there is no histologic criterion of malignancy in this neoplasm, it would be prudent to consider every case of pheochromocytoma as potentially malignant and to follow-up carefully for a long time after removal of the primary tumor.
本文描述了一名71岁男性的恶性嗜铬细胞瘤。在成功切除起源于右肾上腺旁神经节组织的原发性肿瘤12年后，出现了骨转移。尽管患者最初没有儿茶酚胺过量的症状，但在他去世前几个月出现了高血压、心动过速和多汗，同时由于转移性肿瘤的加速生长，去甲肾上腺素分泌急剧增加。由于这种肿瘤没有恶性的组织学标准，谨慎的做法是将每一例嗜铬细胞瘤都视为潜在恶性，并在切除原发性肿瘤后进行长期仔细随访。
