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功能性恶性腹膜后副神经节瘤伴肝转移:一例罕见病例报告

Functional Malignant Retroperitoneal Paraganglioma with Liver Metastasis: a Rare Case Report.

作者信息

Kadam Sachin S, Hegde Sujai, Galage Amol, Kadam Tejaswini

机构信息

Department of Surgical Oncology, Vedant Cancer and Multispeciality Hospital, Mumbai, India.

Department of Surgical Oncology, Kamalnayan Bajaj Cancer Centre, Ruby Hall Clinic, Pune, India.

出版信息

Indian J Surg Oncol. 2021 Apr;12(Suppl 1):186-192. doi: 10.1007/s13193-020-01259-4. Epub 2021 Jan 5.

Abstract

Paragangliomas are rare neoplasms. Their specific annual incidence is still unclear. These are rare neuroendocrine tumors which arise from extra-adrenal paraganglioma and they have the ability to secrete catecholamines. Most of them are diagnosed in the 3rd to 5th decades of life with mean age around 47 years. Majority of them are benign; however, malignant tumors with metastatic behavior are very rare. The incidence of malignant paraganglioma is estimated around 93/400 million people. The clinical course of metastatic malignant disease is variable and the reported 5-year survival is around 12-84%. There is no curative treatment option for malignant metastatic paraganglioma. If resectable, both, primary and metastasis should be resected. The only criteria which defines its malignancy is the presence of metastatic spread of chromaffin cells in tissues that normally do not contain such cells. Functional paraganglioma secretes excessive catecholamines which clinically manifest as paroxysmal hypertension, headache, sweating, and palpitations. We reported a case of young male who presented with huge left retroperitoneal mass and after evaluation found to have a functional malignant paraganglioma with liver metastasis. Surgical resection of the primary malignant paraganglioma with metastatectomy helps in decreasing the complications, improving the symptoms and prolonging the survival.

摘要

副神经节瘤是罕见的肿瘤。其具体的年发病率仍不清楚。这些是罕见的神经内分泌肿瘤,起源于肾上腺外副神经节,具有分泌儿茶酚胺的能力。大多数患者在30至50岁被诊断出来,平均年龄约为47岁。大多数为良性;然而,具有转移行为的恶性肿瘤非常罕见。恶性副神经节瘤的发病率估计约为每4亿人中有93例。转移性恶性疾病的临床病程各不相同,报告的5年生存率约为12%至84%。对于恶性转移性副神经节瘤,没有治愈性的治疗选择。如果可以切除,原发灶和转移灶都应切除。定义其恶性的唯一标准是嗜铬细胞在通常不含此类细胞的组织中发生转移扩散。功能性副神经节瘤分泌过多的儿茶酚胺,临床上表现为阵发性高血压、头痛、出汗和心悸。我们报告了一例年轻男性患者,其左腹膜后出现巨大肿块,经评估发现患有功能性恶性副神经节瘤并伴有肝转移。手术切除原发性恶性副神经节瘤并进行转移灶切除有助于减少并发症、改善症状并延长生存期。

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本文引用的文献

1
Pheochromocytoma and Paraganglioma.嗜铬细胞瘤和副神经节瘤。
N Engl J Med. 2019 Aug 8;381(6):552-565. doi: 10.1056/NEJMra1806651.
5
Mediastinal paraganglioma fed by the left circumflex artery.由左旋支动脉供血的纵隔副神经节瘤。
Interact Cardiovasc Thorac Surg. 2016 Nov;23(5):835-836. doi: 10.1093/icvts/ivw197. Epub 2016 Jul 1.

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