Kawano M, Kodama T, Ito Y, Obara T, Fujimoto Y
Department of Endocrine Surgery, Tokyo Women's Medical College, Japan.
Nihon Geka Gakkai Zasshi. 1989 Dec;90(12):2031-6.
During the last 7 years, operation was performed for 94 cases of adrenal tumor in our series, of which 14 were incidentally found by abdominal computed tomography or echography. They included 9 cases of pheochromocytoma, 1 of Cushing's syndrome, 3 of ganglioneuroma and 1 of cortical adenoma. Five of 9 pheochromocytoma cases were devoid of hypertension, but all 9 cases had abnormally high levels of urinary catecholamines and/or their metabolites. The 4-year autopsy series of Japan (1980-1983) included about 153,000 cases. Except the metastatic tumors, the following lesions were incidentally found in the adrenal gland: 310 of cortical adenoma, 153 of cortical hyperplasia, 39 of pheochromocytoma and 17 cases of neurogenic tumors. Some of the cortical adenomas are presumed to be more than 1 cm in diameter. So, they are expected to be found incidentally, more frequently in the future. Surgery is not necessary for most of them, except for functioning tumors. Most of the pheochromocytomas are presumed to be hormonally active, and should be treated surgically. It is probable that these functioning tumors had been missed clinically, especially in the elderly persons. Neurogenic tumors and myelolipomas may be left in place, when malignancy can be ruled out.
在过去7年中，我们共对94例肾上腺肿瘤患者进行了手术，其中14例是通过腹部计算机断层扫描或超声检查偶然发现的。这些病例包括9例嗜铬细胞瘤、1例库欣综合征、3例神经节瘤和1例皮质腺瘤。9例嗜铬细胞瘤患者中有5例无高血压，但所有9例患者的尿儿茶酚胺和/或其代谢产物水平均异常升高。日本1980 - 1983年的4年尸检系列包括约153,000例病例。除转移性肿瘤外，肾上腺偶然发现的病变如下：皮质腺瘤310例、皮质增生153例、嗜铬细胞瘤39例和神经源性肿瘤17例。一些皮质腺瘤直径推测超过1厘米。因此，预计未来会更频繁地偶然发现它们。除功能性肿瘤外，大多数此类肿瘤无需手术治疗。大多数嗜铬细胞瘤推测具有激素活性，应手术治疗。很可能这些功能性肿瘤在临床上被漏诊了，尤其是在老年人中。当排除恶性肿瘤时，神经源性肿瘤和髓样脂肪瘤可予保留。
