Beatty O L, Russell C F, Kennedy L, Hadden D R, Kennedy T L, Atkinson A B
Sir George E. Clark Metabolic Unit, Royal Victoria Hospital, Belfast, Northern Ireland.
Eur J Surg. 1996 Sep;162(9):695-702.
To report our experience of 41 patients with phaeochromocytoma.
Retrospective study.
Teaching hospital, United Kingdom.
Forty-one patients who presented with phaeochromocytoma 1970-1991.
Removal of tumour (n = 38).
Mortality, morbidity, and recurrence.
Thirty-four patients had sporadic tumours, five had the multiple endocrine neoplasia (MEN) type 2 syndrome, and two had non-MEN familial phaeochromocytoma. Thirty-six patients (88%) presented with symptoms of catecholamine excess, and 37 (90%) were hypertensive. The diagnosis was confirmed biochemically in 37. Tumours were located using computed tomography (n = 26), vascular studies (n = 11), and ultrasonography (n = 3). Thirty-eight patients had their tumours resected, of whom 10 (27%) developed complications. There were no postoperative deaths. Two patients were managed conservatively, and one died before diagnosis. Six patients developed recurrent tumours a mean of five years after the initial operation, and another patient had an inoperable tumour at initial diagnosis; four of these seven died from metastatic disease. Metaiodobenzylguanidine (MIBG) scans were positive in three of the patients who developed recurrences.
Patients with phaeochromocytoma can now be operated on safely but prolonged follow-up is essential.
报告我们对41例嗜铬细胞瘤患者的治疗经验。
回顾性研究。
英国教学医院。
1970年至1991年间出现嗜铬细胞瘤的41例患者。
切除肿瘤（n = 38）。
死亡率、发病率和复发情况。
34例患者患有散发性肿瘤，5例患有2型多发性内分泌腺瘤病（MEN）综合征，2例患有非MEN家族性嗜铬细胞瘤。36例患者（88%）出现儿茶酚胺过量症状，37例（90%）患有高血压。37例经生化检查确诊。通过计算机断层扫描（n = 26）、血管造影（n = 11）和超声检查（n = 3）确定肿瘤位置。38例患者的肿瘤被切除，其中10例（27%）出现并发症。术后无死亡病例。2例患者接受保守治疗，1例在诊断前死亡。6例患者在初次手术后平均5年出现复发性肿瘤，另1例患者在初次诊断时肿瘤无法切除；这7例患者中有4例死于转移性疾病。复发的3例患者间碘苄胍（MIBG）扫描呈阳性。
嗜铬细胞瘤患者现在可以安全地进行手术，但长期随访至关重要。
