Liu Yu-jun, Wang Guo-min, Zhang Yong-kang, Zhang Li, Sun Li-an, Lin Zong-ming, Zhu Tong-yu
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Wai Ke Za Zhi. 2007 Jan 15;45(2):124-7.
To analyze the clinical features of adrenal metastasis.
From January 1993 to December 2004, 103 cases of adrenal metastasis were reviewed.
Lung and hepatocellular carcinoma were the most common primary tumor of adrenal metastatic tumor, which about 36.9% (38/103) and 42.7% (44/103) of all cases, followed by renal carcinoma 6.8% (7/103), colorectal carcinoma 4.9% (5/103), stomach carcinoma 3.9% (4/103), breast cancer 1.9% (2/103), unknown primary tumor 2.9% (3/103). Most of these were low differentiation. The mean diameter of adrenal metastasis was 3.9 cm. The mean interval from detection of primary tumor to adrenal metastasis was 9.5 months. And 79.6% (82/103) were detected as a part of multiorgan metastasis. Only 5 cases (4.9%) were presented with pain in the back. There was little characterization of ultrasonography, CT and MRI, color-Doppler and selective arterial imaging showed little blood supply. All of patients were treated with synthetic methods, 16 cases (15.5%) who had undergone adrenalectomy for metastasis disease had a improved survival compared with those non-adrenalectomy.
There is no particular presentation of clinic and imaging, diagnosis depending on history, follow-up and the pathological presentation of primary tumor. There are no standard treatment guidelines for this group of patients. When the primary tumor could be resected or be well controlled, and there is no other evidence of metastasis, adrenalectomy is recommended. Transarterial chemoembolization (TACE) could not actually be performed.
分析肾上腺转移瘤的临床特征。
回顾性分析1993年1月至2004年12月期间收治的103例肾上腺转移瘤患者的临床资料。
肾上腺转移瘤最常见的原发肿瘤为肺癌和肝细胞癌,分别占所有病例的36.9%(38/103)和42.7%(44/103),其次为肾癌6.8%(7/103)、结直肠癌4.9%(5/103)、胃癌3.9%(4/103)、乳腺癌1.9%(2/103)、原发肿瘤不明2.9%(3/103)。多数为低分化。肾上腺转移瘤的平均直径为3.9 cm。从原发肿瘤发现至肾上腺转移的平均间隔时间为9.5个月。79.6%(82/103)的患者被检测出为多器官转移的一部分。仅5例(4.9%)患者出现背痛。超声、CT和MRI表现缺乏特异性,彩色多普勒及选择性动脉造影显示血供较少。所有患者均采用综合治疗方法,16例(15.5%)因转移瘤接受肾上腺切除术的患者与未行肾上腺切除术的患者相比,生存期有所改善。
肾上腺转移瘤无特殊的临床及影像学表现,诊断依赖于病史、随访及原发肿瘤的病理表现。对于这类患者尚无标准的治疗指南。当原发肿瘤可切除或得到良好控制,且无其他转移证据时,建议行肾上腺切除术。实际上无法进行经动脉化疗栓塞术(TACE)。