Kageyama S, Ihara H, Kurita Y, Ueda D, Ushiyama T, Ohtawara Y, Suzuki K, Kawabe K
Department of Urology, Hamamatsu University School of Medicine.
Nihon Naibunpi Gakkai Zasshi. 1993 Nov 20;69(10):1076-82. doi: 10.1507/endocrine1927.69.10_1076.
A 31-year-old male was admitted to our hospital for further examination of a right adrenal mass, which was incidentally discovered by abdominal ultra-sonography in another hospital. The adrenaline and noradrenaline in the plasma and the adrenaline and VMA in the urine were slightly elevated, and catecholamines in the blood from the right adrenal vein were markedly increased. Glucose tolerance test showed a borderline case. Otherwise, there was no clinical sign. Asymptomatic pheochromocytoma originating from the right adrenal gland was suspected in the preoperative diagnosis. Laparoscopic right adrenalectomy was performed. Although the blood pressure was stable preoperatively, paroxysmal hypertension was observed during the tumor manipulation. Blood pressure was well controlled during the operation with ATP, nitroglycerin and phentolamine. Blood loss was less than 150ml, and there was no surgical complication. The resected tumor specimen was 32[28[33mm in size, weighed 14g, and histological examination showed typical pheochromocytoma. The post-operative course was unremarkable and glucose tolerance test was normalized after the operation. This is the first case of the successful removal of pheochromocytoma using the laparoscopic procedure.
一名31岁男性因右肾上腺肿物进一步检查入院，该肿物是在另一家医院行腹部超声检查时偶然发现的。血浆中的肾上腺素和去甲肾上腺素以及尿中的肾上腺素和香草扁桃酸（VMA）轻度升高，右肾上腺静脉血中的儿茶酚胺显著增加。葡萄糖耐量试验显示为临界情况。除此之外，无临床症状。术前诊断怀疑为起源于右肾上腺的无症状嗜铬细胞瘤。行腹腔镜右肾上腺切除术。尽管术前血压稳定，但在肿瘤操作过程中观察到阵发性高血压。术中使用三磷酸腺苷（ATP）、硝酸甘油和酚妥拉明，血压得到良好控制。出血量少于150ml，无手术并发症。切除的肿瘤标本大小为32[28[33mm，重14g，组织学检查显示为典型的嗜铬细胞瘤。术后病程平稳，术后葡萄糖耐量试验恢复正常。这是首例成功采用腹腔镜手术切除嗜铬细胞瘤的病例。
