Galifer R B, Pous J G, Noblet D
Chir Pediatr. 1982 Mar-Apr;23(2):121-4.
This is a case report of a malignant pheochromocytoma in a 10 years old boy with attacks of abdominal pains, diarrhea, visual difficulties and hypertension. No familial history was noted. At that time, a large functionally active and extraadrenal tumor was surgically removed just above the diaphragm. 3 years later, a retroperitoneal active recurrence required a 2nd operation. Then, a vertebral invading obliged to resect almost the whole T 12 and to stabilise the rachis with a double osteosynthesis, by a posterior and anterior approach. Although this may represent compression and invasion of the bone rather than a true metastasis, the authors think that the clinical course demonstrates malignancy. They emphasize the fact that the acceptance of strict criteria should help to overcome much of the confusion regarding the diagnosis of a malignant pheochromocytoma. It is generally accepted that such a diagnosis cannot be made in the absence of metastases, irrespective of the histologic picture. The technical problems of peri-neural surgery are also discussed.
这是一例10岁男孩患恶性嗜铬细胞瘤的病例报告，该男孩有腹痛、腹泻、视力障碍和高血压发作。未发现家族病史。当时，在膈肌上方手术切除了一个大的功能性活跃的肾上腺外肿瘤。3年后，腹膜后活动性复发需要进行第二次手术。随后，肿瘤侵犯椎体，不得不切除几乎整个T12，并通过前后入路进行双重骨固定以稳定脊柱。尽管这可能代表骨的压迫和侵犯而非真正的转移，但作者认为临床病程显示为恶性。他们强调，采用严格标准有助于克服恶性嗜铬细胞瘤诊断方面的许多困惑。人们普遍认为，无论组织学表现如何，在没有转移的情况下不能做出这种诊断。文中还讨论了神经周围手术的技术问题。
