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1、2008年6月基础医学与临床June2008第28卷第6期Basic&ClinicalMedicineVo.l28No.6文章编号:10016325(2008)06064605临床园地腹膜后静止型副神经节细胞瘤的临床诊治*文进,李汉忠,石冰冰(中国医学科学院中国协和医科大学北京协和医院泌尿外科,北京100730)摘要:目的提高腹膜后功能静止型副神经节细胞瘤的诊断和治疗水平。方法分析1997年至今资料完整、病理证实的功能静止型副神经节细胞瘤10例。术前行内分泌、影像学及核医学等检查。4例术前服用2
2、~4周受体拮抗剂。3例接受腹腔镜手术,7例接受经腹开放手术。结果功能静止型副神经节细胞瘤患者血压及尿儿茶酚胺通131常为正常或稍高,IMIBG和奥曲肽显像定位准确、敏感性高。4例肿瘤位于肾门旁,6例位于肾下方腹主动脉旁,直径3~15cm。术后病理结果:7例为副神经节细胞瘤,3例为恶性副神经节细胞瘤。免疫组化染色:cgA(+),syn(+),NSE(+),s100(+)。1例恶性副神经节细胞瘤于术后1年发生全身转移。结论一旦确诊功能静止型副神经节细胞瘤,应该在充分药物准备的基础上,手术切除肿瘤,术后应密切
3、随访。关键词:静止型;副神经节细胞瘤;腹膜后中图分类号:R73文献标志码:ADiagnosisandtreatmentofstationaryparagangliomainretroperitoneum*WENJin,LIHanzhong,SHIBingbing(DepartmentofUrology,PUMCHospita,lCAMU&PUMC,Beijing100730,China)Abstract:ObjectiveTohighlightthediagnoseandtreatmentofst
4、ationaryparagangliomainretroperitoneum.MethodsTencasesofstationarymedullarychromaffinomaofretroperitoneumprovenpathologicallyfrom1997to2007werereviewedandsutdied.Hypertensionwerenotobservedinallpatients,whowereadmittedtohospital131throughroutinephisicalex
5、amination.Endocrinesecretionexaminations,BUS,CT,MRI,IMIBG,andoctreotidewereusedtodianosethediease.Amongall10patients,4casestookreceptorblockerfor2~4weekspreoperatively.3wereoperatedlaparoscopically,7wereoperatedwithlumberincision.ResultsHypertensiona
6、ndurinarycatecholaminewasusuallynormalorelevatedlightlyinstationarymedullarychromaffinomaofretroperitoneum.131andoctreotidehavehighsensitivityandaccuracyindiagosingmedullarychromaffinoma.4werenearrenalhilum,6wasinparaaorta.Theywerefrom3cmto15cminsize.Ther
7、esultsofpathologywereparagangliomain7andmalignantparagangliomain3.Tumormarkerswerepositive,suchascgA,syn,NSEands100.Therewas1casemetastasis1yearslater.ConclusionOncethecorrectdiagnosisismade,surgicaltreatmentshouldbecarryoutonthebasisofcorrectdrugprepara
8、tion.Intimatefollowupisnecessaryandimportan.tKeywords:stationary;paraganglioma;retroperitoneum收稿日期:2008-03-18修回日期:2008-04-24*通信作者(correspondingauthor):010-86874753;wjjxmc@163.com2008.28(6)基础医学与临床Ba
