Kobayashi Hiroaki, Kaneko Gou, Nishimoto Koshiro, Uchida Atushi
The Department of Urology, Kyosai Tachikawa Hospital.
Hinyokika Kiyo. 2009 Dec;55(12):749-52.
Pheochromocytoma occurs in 0.1 to 5.7% of patients with type 1 neurofibromatosis (NF1). Radiological findings of pheochromocytoma are often similar to those of neurofibroma; therefore, any pheochromocytoma should be excised in hypertensive patients with NF1. A 60-year-old male patient with NF1 was referred to this hospital for an incidentally discovered right adrenal mass, 7 x 6 mm in diameter. The patient had multiple benign tumors and suffered from hypertension for 4 years. Laboratory findings showed increased serum and urine catecholamine levels. Magnetic resonance imaging (MRI) revealed a high signal intensity on T2-weighted images, which was enhanced by gadolinium contrast. The mass was positive for 131 I-metaiodobenzylguanidine (MIBG) scintigraphy. A laparoscopic adrenalectomy was performed. A histopathological diagnosis of pheochromocytoma was made. The patient's post-operative course was uneventful, and blood pressure was normalized. Screening of the adrenal tumor is strongly recommended for NF1 patients with hypertension, since any unfavorable events due to catecholamine such as cardiomyopathy and fatal arrhythmia can be avoided by adequate surgical intervention.
嗜铬细胞瘤发生于1型神经纤维瘤病(NF1)患者中的比例为0.1%至5.7%。嗜铬细胞瘤的放射学表现通常与神经纤维瘤相似;因此,对于患有NF1的高血压患者,任何嗜铬细胞瘤均应切除。一名60岁的NF1男性患者因偶然发现右侧肾上腺有一个直径7×6毫米的肿块而被转诊至本院。该患者有多个良性肿瘤,患有高血压4年。实验室检查结果显示血清和尿儿茶酚胺水平升高。磁共振成像(MRI)显示在T2加权图像上呈高信号强度,钆对比剂增强。该肿块131I-间碘苄胍(MIBG)闪烁扫描呈阳性。进行了腹腔镜肾上腺切除术。作出了嗜铬细胞瘤的组织病理学诊断。患者术后病程顺利,血压恢复正常。强烈建议对患有高血压的NF1患者进行肾上腺肿瘤筛查,因为通过适当的手术干预可以避免因儿茶酚胺引起的任何不良事件,如心肌病和致命性心律失常。