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目的总结肾上腺转移性肿瘤的临床特点。方法回顾性分析103例肾上腺转移性肿瘤患者的临床资料。结果在103例患者中,原发肿瘤为肺癌38例(36.9%),肝癌44例(42.7%),肾癌7例(6.8%),结肠癌5例(4.9%),贲门、胃癌4例(3.9%),乳腺癌2例(1.9%),来源未明的恶性肿瘤3例(2.9%);原发肿瘤多分化不良。转移瘤直径平均3.9 cm;从发现原发肿瘤到肾上腺转移,平均时间为9.5个月。82例患者(79.6%)伴有其他脏器或淋巴结转移。5例(4.9%)患者有患侧腰痛;B 超、CT、MRI 无特殊征象,彩色多谱勒超声和选择性动脉造影无明显供血。大多采用综合治疗,肾上腺切除16例(15.5%),生存时间略优于非手术患者。结论肾上腺转移性肿瘤并不罕见,多数失去手术机会。根据病史、随访及原发肿痛的病理特点,结合影像学表现,多可明确诊断。肾上腺切除适用于原发肿瘤可以切除或有效控制且无其他脏器转移者,可望延长患者生存时间;介入治疗难以精确实施。
Objective To summarize the clinical characteristics of adrenal metastatic tumors. Methods The clinical data of 103 adrenal metastatic tumors were retrospectively analyzed. Results Of the 103 patients, 38 (36.9%) had primary lung cancer, 44 (42.7%) had liver cancer, 7 (6.8%) had kidney cancer, 5 (4.9%) had colon cancer and 4 (3.9%), 2 cases of breast cancer (1.9%), 3 cases of unspecified malignant tumors (2.9%), and poorly differentiated primary tumors. Metastatic tumors average 3.9 cm in diameter; from primary tumor to adrenal metastasis, the mean time was 9.5 months. 82 patients (79.6%) with other organs or lymph node metastasis. Five patients (4.9%) had ipsilateral lower back pain. There were no special signs of ultrasound, CT and MRI. There was no obvious blood supply in color Doppler ultrasound and selective arteriography. Mostly using comprehensive treatment, adrenalectomy in 16 cases (15.5%), survival time slightly better than non-surgical patients. Conclusion Adrenal metastatic tumors are not uncommon, most of the lost opportunities for surgery. According to history, follow-up and primary pathological features of swelling and pain, combined with imaging findings, can be more clear diagnosis. Adrenalectomy for primary tumors can be removed or effectively controlled and no other organ metastasis, is expected to extend the survival time of patients; interventional treatment is difficult to accurately implement.