Li Ze-liang, Sun Dan, Kong Chui-ze
Department of Urology, First Affiliated Hospital of China Medical University, Shenyang 110001, China.
Zhonghua Wai Ke Za Zhi. 2009 Aug 15;47(16):1239-41.
To study and summarize the diagnosis and treatment for the corticomedullary mixed tumor of adrenal gland.
The clinical data of 25 cases of adrenal corticomedullary mixed tumor from January 2000 to April 2008 were analyzed retrospectively, which including 9 males and 16 females. The ages were from 25 to 60 years old, and the average age was 39 years old. Thirteen cases had paroxysmal hypertension and 11 cases had central obesity, as well as 8 cases with hypokalemia. There were different degree abnormalities in plasma endocrine hormones in laboratory examination. Every case underwent b-ultrasound and CT normal plus extensive scan to make the diagnosis.
Adrenalectomy was performed in the 25 cases, which contain 9 cases of open operations and 16 cases of endoscopic adrenalectomies. All of the cases had blood pressure fluctuation during dissection of the adrenal tumors, with the highest blood pressure reached to 230/140 mm Hg (1 mm Hg = 0.133 kPa). Postoperative histopathological study revealed that the pathological changes was corticomedullary mixed tumor of adrenal gland, which was supported by immunohistochemical study.
In cases with complex phenomenon that can't explain with single cortical or medullary changes, it must beware of the mixed pathological changes in adrenal gland.
研究并总结肾上腺皮质髓质混合瘤的诊断与治疗方法。
回顾性分析2000年1月至2008年4月收治的25例肾上腺皮质髓质混合瘤患者的临床资料,其中男性9例,女性16例。年龄25~60岁,平均39岁。13例有阵发性高血压,11例有向心性肥胖,8例有低钾血症。实验室检查血浆内分泌激素有不同程度异常。所有病例均行B超、CT平扫加增强扫描以明确诊断。
25例均行肾上腺切除术,其中开放手术9例,腔镜下肾上腺切除术16例。所有病例在肾上腺肿瘤切除过程中均有血压波动,最高血压达230/140 mmHg(1 mmHg = 0.133 kPa)。术后病理组织学检查显示为肾上腺皮质髓质混合瘤,免疫组化检查支持该诊断。
对于出现单一皮质或髓质改变无法解释的复杂现象的病例,必须警惕肾上腺存在混合性病理改变。