成人腎上腺皮質(zhì)癌的診斷和治療（文獻(xiàn)綜述并16例報(bào)告）.pdf

1、成人腎上腺皮質(zhì)癌的診斷和治療(文獻(xiàn)綜述并l6例報(bào)告)摘要盡的探討成人腎上躲皮質(zhì)癌的臨床特點(diǎn)和治療方法。方法總結(jié)16例成人腎上腺皮質(zhì)癌，男性7例，女性9例，平均年齡424歲。其中臨床表現(xiàn)為功能性腫痛2例(i25％)：1例表現(xiàn)為柯興氏綜合征并性征異常，1例表現(xiàn)為醛閹酮增多癥。無功能性腫瘤l4例(875％)。全部患者術(shù)前行B超、CT等影像學(xué)檢查，10例接受內(nèi)分泌激素檢測(cè)。結(jié)果術(shù)前l(fā)3例明確診斷為本病。患者均蓄先行手術(shù)治療，術(shù)舞病理l期Jl孛瘤

2、3例，II期9例，III期4例。手術(shù)完整切除腫瘤13例，隨訪1462個(gè)月，平均生存期48個(gè)胃；有5倒至今存活。其中3鍘，毽括2佛II期、l傭III期因術(shù)后812個(gè)月出現(xiàn)轉(zhuǎn)移(2例肺轉(zhuǎn)移，1例肝轉(zhuǎn)移)面進(jìn)展為Ⅳ期，分別轉(zhuǎn)我院內(nèi)科舒以順鍵為主鶼聯(lián)合傀療(PDDADMVP16)35周期，均未達(dá)到腫瘸緩解(1例SD2例PD)，術(shù)后平均生存期l7個(gè)月。放療組均未控，2倒分剮于術(shù)厝35個(gè)勞局部復(fù)發(fā)，回當(dāng)?shù)乇Ｊ刂委煟?例予放療結(jié)束后4個(gè)月出現(xiàn)廣1Di

3、agnosisandmanagementofadren刪carcinomainadults：aliteraturereviewand16casesrepo域AbstractObjectiveTostudytheclinicalfeaturesdiagnosisandmanagementofadrenocorticalcarcinomainadults。Method16casesofadrenocorticalcarcinomainadu

4、lts精7疆棼reviewedincluding7metland9womenwhoseaverageageis424yearsold。EndocrinosisWdSinvolvedin2padents：aWOlDanwassufferedfromCushingssyndmrneandvirlization越堪a玨珞蘸w蕊admittedforpnmaryatdosteronismInother14patients，theirtumors

5、weredescribedasnonfuctional。Radiologicevaluationwereperformedinallcases，includingultrasoundandCTscanandendocrinologicevaluationperformedin10patientsResults13casesweredefinitelydiagnosedasadrenocorticalcarcinomabeforeoper

6、ationPathologyresultsproved3stageIGases9stageIIcasesand4stageHIones13of16pa蛀entsunder蝴tradicaladrenolectomywiththemedianatrvivaltimeof48monthswhereasthemediansurvival婦of3otherpatientswhounderwentpalliativeresectionandrad

7、iationtherapywasonlylImonthsMetastasesoccurredin3patientswhohadunderwentcompleteresectionandalthoughchemotherapywasgiven，nosignificantrespot粥wasobservedConclusionadrenocortiealcarcinomaisarareaggressiveandlethalmalignanc

8、yRadiologicevaluationisthekeywaytofindingoutnonfunctionaltumorEarlierdetectionandcompleteinitialsurgicalresectionappear幻offerthebesthopeforoutcomeimprovementbynowKeywordadrenoc蕊calc翻cinomainadultradiologicevaluationcompl