Abeatici S, Durando R, Palestini N, Maquignaz M G
Ann Urol (Paris). 1986;20(6):369-72.
The authors evaluated and operated 40 cases of Cushing's syndrome, 8 cases of Conn's syndrome and 19 cases of phaeochromocytoma. The diagnosis was frequently delayed due to inadequate hormonal analysis. Cancer of the adrenal gland was observed in 17% of cases of Cushing's syndrome, while all cases of Conn's syndrome corresponded to an adenoma. There was a female predominance for both Cushing's syndrome and Conn's syndrome. Four malignant lesions were observed in the series of 19 tumours of the adrenal medulla (21% of cases). CT scan was found to be the most accurate of modern diagnostic techniques and was able to define the site and the dimensions of the adrenal tumour. Arteriography was particularly useful in cases with large, highly vascular tumours. The preferred surgical approach was lumbotomy, less frequently laparotomy, and, in cases of invasive tumour, thoraco-phreno-laparotomy. Removal of the tumour by adrenalectomy led to resolution of the symptoms and, in benign cases, complete cure.
作者对40例库欣综合征、8例原发性醛固酮增多症和19例嗜铬细胞瘤患者进行了评估和手术治疗。由于激素分析不足，诊断常常延迟。在库欣综合征病例中，17%观察到肾上腺癌，而所有原发性醛固酮增多症病例均为腺瘤。库欣综合征和原发性醛固酮增多症均以女性居多。在19例肾上腺髓质肿瘤系列中观察到4例恶性病变（占病例的21%）。CT扫描被认为是现代诊断技术中最准确的，能够确定肾上腺肿瘤的部位和大小。动脉造影在肿瘤大、血供丰富的病例中特别有用。首选的手术方法是腰切口，较少采用剖腹手术，对于侵袭性肿瘤则采用胸腹联合切口。通过肾上腺切除术切除肿瘤可使症状缓解，在良性病例中可实现完全治愈。
