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14例无功能嗜铬细胞瘤的临床诊断与治疗

Clinical diagnosis and treatment of nonfunctioning pheochromocytomas in 14 patients.

作者信息

Pan Dong-liang, Li Han-zhong, Zeng Zheng-pei, Li Fang, Cui Quan-cai

机构信息

Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing.

出版信息

Chin Med Sci J. 2005 Jun;20(2):126-8.

Abstract

OBJECTIVE

To analyze the clinical characteristics of nonfunctioning pheochromocytoma, and to evaluate the efficacy of 131I-metaiodobenzylguanidine (MIBG) scan in the diagnosis and perioperative treatment of nonfunctioning pheochromocytoma.

METHODS

The clinical data of 14 patients with nonfunctioning pheochromocytoma were analyzed retrospectively. Plasma free corticoid, renin, aldosterone, and urine catecholamines levels were estimated. B-mode ultrasonography, computed tomography scan, thoracic X-ray and 131I-MIBG were used.

RESULTS

All patients with nonfunctioning pheochromocytoma had no hypertension and the tumors were found incidentally. The 24 hours urine catecholamines levels in 80% (8/10) patients were normal. The positive rate of 131-MIBG was 80% (8/10) and the specificity was 100%. All patients underwent surgical operation of tumor resection. No preoperative volume expansion was given to all patients. All tumors were resected completely, and no death accident happened. There was no recurrence and metastasis after operation by long-term follow-up.

CONCLUSION

131I-MIBG scan is the first choice technique for the diagnosis of nonfunctioning pheochromocytoma. Blood volume expansion is unnecessary before resection of pheochromocytoma.

摘要

目的

分析无功能嗜铬细胞瘤的临床特点,评价¹³¹I -间碘苄胍(MIBG)扫描在无功能嗜铬细胞瘤诊断及围手术期治疗中的作用。

方法

回顾性分析14例无功能嗜铬细胞瘤患者的临床资料。检测血浆游离皮质醇、肾素、醛固酮及尿儿茶酚胺水平。采用B型超声、计算机断层扫描、胸部X线及¹³¹I - MIBG检查。

结果

所有无功能嗜铬细胞瘤患者均无高血压,肿瘤均为偶然发现。80%(8/10)患者24小时尿儿茶酚胺水平正常。¹³¹I - MIBG阳性率为80%(8/10),特异性为100%。所有患者均行肿瘤切除术,术前均未进行扩容。所有肿瘤均完整切除,无死亡病例。长期随访无复发及转移。

结论

¹³¹I - MIBG扫描是诊断无功能嗜铬细胞瘤的首选技术。嗜铬细胞瘤切除术前无需扩容。

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