Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
J Clin Hypertens (Greenwich). 2013 Jun;15(6):428-34. doi: 10.1111/jch.12084. Epub 2013 Mar 15.
Pheochromocytomas and paragangliomas are rare tumors with high morbidity rates caused by excessive catecholamine secretion, even though the majority of tumors are benign. The use of perioperative blockade regimens, together with improved surgical techniques, has greatly impacted the perioperative morbidity associated with these tumors. The old dogma of the "tumor of tens" no longer holds true. For example, at least one third of all pheochromocytomas and paragangliomas are hereditary, with mutations in 1 of 10 well-characterized susceptibility genes, and one quarter of all tumors are malignant. This review focuses on the perioperative management of pheochromocytoma and paragangliomas and the clinical implications of the associated genetic mutations.
嗜铬细胞瘤和副神经节瘤是由儿茶酚胺分泌过多引起的罕见肿瘤,发病率很高,尽管大多数肿瘤是良性的。围手术期阻断方案的应用,以及手术技术的提高,极大地降低了与这些肿瘤相关的围手术期发病率。“肿瘤十定律”的旧观念不再成立。例如,至少有三分之一的嗜铬细胞瘤和副神经节瘤是遗传性的,与 10 个已知易感性基因中的 1 个突变有关,四分之一的肿瘤是恶性的。本综述重点介绍了嗜铬细胞瘤和副神经节瘤的围手术期管理以及相关基因突变的临床意义。