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目的:总结肾上腺转移癌的临床特点与诊治体会。方法:回顾性分析1996年12月～2010年2月收治的肾上腺转移癌患者45例临床资料:原发肿瘤包括肺癌23例(51.1%),肝癌5例(11.1%),肾癌5例(11.1%),乳腺癌4例(8.9%),黑色素瘤2例(4.4%),其他肿瘤6例(13.3%)。临床表现为全身乏力、消瘦、贫血或低热16例,患侧腰背部胀痛8例,高血压6例。均行B超、CT、MRI及正电子发射断层扫描(PET)检查确诊。35例行手术治疗,10例放弃手术。结果:完整切除转移癌者30例获得随访,生存6～62个月,平均34.2±4.7个月,最长存活已5年2个月;5例失访。10例放弃手术者中,6例获得随访,生存4～8个月,平均6.3±2.7个月,均死于肿瘤晚期或多发转移。结论:对原发肿瘤应重视术中及术后肾上腺部位的检查及随访。B超及CT是诊断肾上腺转移癌的重要检查方法,PET对诊断肾上腺转移癌有较高的临床价值。完整切除肾上腺转移灶可延长患者生存期,但需严格控制适应证。
Objective: To summarize the clinical features, diagnosis and treatment of adrenal metastasis. Methods: The clinical data of 45 patients with adrenal metastasis from December 1996 to February 2010 were retrospectively analyzed. The primary tumors included 23 cases of lung cancer (51.1%), 5 cases of liver cancer (11.1%) and 5 cases of renal cell carcinoma 11.1%), 4 cases of breast cancer (8.9%), 2 cases of melanoma (4.4%) and 6 cases of other tumors (13.3%). Clinical manifestations of malaise, weight loss, anemia or fever in 16 cases, ipsilateral lower back pain in 8 cases, 6 cases of hypertension. All patients underwent ultrasound, CT, MRI and positron emission tomography (PET) examination. 35 patients underwent surgical treatment and 10 patients gave up surgery. Results: Thirty patients with complete resection and metastasis were followed up for 6 to 62 months with an average of 34.2 ± 4.7 months. The longest survival rate was 5 years and 2 months. Five patients were lost to follow-up. Of the 10 patients who gave up surgery, 6 were followed up for 4 to 8 months with an average of 6.3 ± 2.7 months, all of whom died of advanced or multiple tumor metastases. Conclusion: The primary tumor should pay attention to intraoperative and postoperative adrenal site examination and follow-up. B ultrasound and CT is an important method for the diagnosis of adrenal metastases, PET has a high clinical value in the diagnosis of adrenal metastases. Complete removal of adrenal metastases can extend the survival of patients, but the need to strictly control indications.