Lobo-Sanahuja F, Estrada-Molina Y, González M, Calzada L D, Fuscaldo C, Artavia-Loría E, García I
Servicio de Oncología, Hospital Nacional de Niños, San José, Costa Rica.
Bol Med Hosp Infant Mex. 1993 Sep;50(9):655-61.
In the last 20 years, eleven children with adrenocortical functional tumors were treated in the National Children Hospital of Costa Rica. There were nine females and two males and their ages ranged from nine months to 14 years. Eleven patients had features of virilism, five had stigmas of Cushing's syndrome and three hyperaldosteronism. The clinical diagnosis was established given the symptoms, hormonal tests and radiological and imagenological studies. The histologic diagnosis was carcinoma in six by clinical picture in one, and were adenoma in four. Three patients had regional and distant metastases. Four patients with carcinoma were treated by surgery and five received chemotherapy, two of them in presurgical stage, and four received radiotherapy. Two patients with carcinoma are alive and had no evidence of tumor recurrence ten and six years after diagnosis. Five are dead, two of them after partial response to chemotherapy. The four patients with adenoma were cured by complete surgical tumor resection, furthermore one of them received chemotherapy because there was not sure of his histologic benign condition. It is necessary more studies in use of chemotherapy in treatment of this tumors but in our experience CFM, VCR, Epi and Actin is a regimen that appears to be an active combination for the treatment in presurgical stage of adrenal cortical carcinoma.
在过去20年里,哥斯达黎加国家儿童医院收治了11例肾上腺皮质功能性肿瘤患儿。其中9例为女性,2例为男性,年龄从9个月至14岁不等。11例患者有男性化特征,5例有库欣综合征体征,3例有醛固酮增多症。根据症状、激素检测以及放射学和影像学检查确立临床诊断。组织学诊断为癌的有6例,根据临床表现诊断为癌的有1例,腺瘤有4例。3例患者有局部和远处转移。4例癌患者接受了手术治疗,5例接受了化疗,其中2例在术前阶段接受化疗,4例接受了放疗。2例癌患者存活,诊断后10年和6年无肿瘤复发迹象。5例死亡,其中2例在对化疗有部分反应后死亡。4例腺瘤患者通过完整的肿瘤手术切除治愈,此外,其中1例因组织学良性情况不明确而接受了化疗。有必要对化疗在这类肿瘤治疗中的应用进行更多研究,但根据我们的经验,环磷酰胺、长春新碱、表柔比星和放线菌素是一种在肾上腺皮质癌术前治疗中似乎有效的联合方案。