隐匿性肾上腺肿瘤14例临床和病理分析

金伟 中华内分泌代谢杂志 2000年第3期第16卷 论著

　　【摘要】　目的　分析隐匿性肾上腺肿瘤的临床特征和病理情况。方法　自1995年12月至1997年4月经B超和CT诊断为隐匿性肾上腺瘤共14例，全部患者均作了手术切除及病理检查。结果　14例中10例为无功能肿瘤，4例存在着隐性功能变化，病理检查发现3例为嗜铬细胞瘤，5例发生肾上腺肿块内出血坏死，其瘤体较大，直径在6～16 cm。结论　隐匿性肾上腺瘤是肾上腺最常见的肿瘤。少数有激素分泌。若肿瘤＞3 cm或进行性增大者，均应尽早手术治疗。

　　Clinical and pathological analysis of 14 cases of incidentally discovered adrenal masses

JIN Wei

　　（Department of Endocrinology. The First Hospital Affiliated to Zhejiang University Medical Collage,Hangzhou 310003）

　　【Abstract】　Objective　To analyse the clinical and pathological characteristics of the incidentally discovered adrenal masses (incidentaloma). Methods　Fourteen hospitalized patients with incidentaloma from December 1995 to April 1997 were analysed. They were diagnosed firstly by ultrasound scan and later confimed by computed tomograph. All patients were treated by surgical removal of the masses which were later further underwent pathological study. Results　In 14 patients studied, 10 were without homonal secretion while 4 had hidden functional disturbances. Pathological study revealed that the tumors though were variable in origin, most were nonfunctional, 3 were found to be pheochromacytomas; 5 manifesting hemorrhage and necrosis were those with a bigger size, e.g. 6 to 16 cm in diameter. Conclusion　Incidentalomas are common adrenal tumors. Some do secret hormonas. Those with a diameter over 3 cm or enlarging continuously need resecting surgically as soon as possible.

　　【Key words】　Adrenal gland neoplasmas; Pathology, surgery

　　隐匿性肾上腺肿瘤亦称偶然发现的肾上腺瘤(adrenal incidentaloma)。因常无症状，故亦称无症状或临床静寂的肾上腺肿瘤。多因其他疾病作腹部B超和(或)CT检查时意外发现。随着B超和CT的广泛应用于临床，这种“意外瘤”日趋增多。1994年以前，国内只有少数报道〔1〕。国外1974年统计无症状肾上腺瘤的报道只有178例〔2〕。现将我院1995年12月至1997年4月收治并经手术和病理证实的14例隐匿性肾上腺瘤作一临床分析。

　　对象和方法

　　一、对象

　　14例患者中，男4；女10；年龄34～60岁。其中≥40岁者12例，平均年龄47.9岁。其中2例患者从诊断至手术的时间分别为4年和5年，余者发现肾上腺肿块仅数天至2个月。7例为健康　检　查腹部B超时发现。7例因其它原因在我院门诊就诊时行腹部B超时意外发现。

　　二、方法

　　1.影像学检查：所有病人B超发现肾上腺肿块后均经CT证实。两者检查结

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