Sloan D A, Schwartz R W, McGrath P C, Kenady D E
Department of Surgery, University of Kentucky, Lexington 40536, USA.
Curr Opin Oncol. 1996 Jan;8(1):30-6. doi: 10.1097/00001622-199601000-00006.
Tumors of the adrenal gland are not uncommon. Patients with these tumors usually demonstrate symptoms associated with the biochemical substance or hormone produced by the tumor. Tumors of the adrenal cortex, whether benign or malignant, are often associated with excess production of steroids, whereas tumors of the medulla are generally associated with overproduction of catecholamines. With the ubiquitous use of computed tomographic imaging, many asymptomatic adrenal lesions are discovered, presenting a management problem for the clinician. The algorithm for investigating so-called adrenal "incidentalomas" in the current era of cost containment continues to evolve. This review addresses current trends in the clinical evaluation, biochemical testing, and nuclear and radiologic imaging in the diagnostic work-up of these neoplasms. The mainstay of treatment is still surgical extirpation, the only curative modality. However, advances have occurred in adjuvant therapies, perhaps best typified by the neoadjuvant use of 131I-methyl iodobenzylguanidine in the treatment of neuroblastoma.
肾上腺肿瘤并不罕见。患有这些肿瘤的患者通常会表现出与肿瘤产生的生化物质或激素相关的症状。肾上腺皮质肿瘤，无论良性还是恶性，通常与类固醇分泌过多有关，而髓质肿瘤一般与儿茶酚胺分泌过多有关。随着计算机断层成像的广泛应用，许多无症状的肾上腺病变被发现，这给临床医生带来了管理难题。在当前成本控制的时代，用于研究所谓肾上腺“偶发瘤”的算法仍在不断发展。这篇综述探讨了这些肿瘤诊断检查中临床评估、生化检测以及核医学和放射影像学的当前趋势。治疗的主要手段仍然是手术切除，这是唯一的治愈方式。然而，辅助治疗也有进展，以131I - 间碘苄胍在神经母细胞瘤治疗中的新辅助应用最为典型。
