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经皮穿刺活检诊断为无功能肾上腺皮质癌并对术前化疗有反应的病例报告

[A case report of non-functioning adrenal carcinoma diagnosed by percutaneous needle biopsy and which responded to preoperative chemotherapy].

作者信息

Terashima Y, Nishimura T, Akimoto M, Kim D Y, Tajiri T

机构信息

Department of Urology, Nippon Medical School.

出版信息

Hinyokika Kiyo. 1988 Oct;34(10):1777-82.

PMID:3245526
Abstract

A 51-year-old female complained of right upper abdominal pain. Non-functioning adrenal carcinoma was suspected from the laboratory data of elevated lactate dehydrogenase level and total amount of urinary excretion of 17-ketosteroid. To deny the possibility of other diseases, such as retroperitoneal sarcoma, a percutaneous needle biopsy of the tumor was carried out. As the pathological diagnosis was adrenal carcinoma, pre-operative chemotherapy consisting of cis-dichlorodiammineplatinum (CDDP), adriamycin, 5-fluorouracil, cyclophosphamide and o,p'-DDD was carried out twice. The tumor size decreased after chemotherapy, and we could operate on the patient safely and relatively easily. Almost all of the tumor was replaced by a necrotic mass. However, cancer cells still remained in the peripheral lesion of the tumor, and the pathological diagnosis was the same as that of biopsy specimen. Although chemotherapy of adrenal carcinoma has not been established yet, we believe from the experience of this case that this disease should be treated by chemotherapy including CDDP.

摘要

一名51岁女性主诉右上腹疼痛。根据乳酸脱氢酶水平升高及尿17-酮类固醇排泄总量的实验室数据,怀疑为无功能性肾上腺皮质癌。为排除其他疾病的可能性,如腹膜后肉瘤,对肿瘤进行了经皮穿刺活检。病理诊断为肾上腺皮质癌后,进行了两次术前化疗,化疗方案包括顺二氯二氨铂(CDDP)、阿霉素、5-氟尿嘧啶、环磷酰胺和邻对滴滴滴。化疗后肿瘤大小缩小,我们能够安全且相对轻松地为患者实施手术。几乎整个肿瘤都被坏死组织替代。然而,肿瘤周边病变仍有癌细胞残留,病理诊断与活检标本相同。尽管肾上腺皮质癌的化疗方案尚未确立,但从该病例的经验来看,我们认为这种疾病应采用包括CDDP在内的化疗进行治疗。

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