治療及預後:隨著腹腔鏡技術在泌尿外科的廣泛應用,經腹腔鏡切除腎上腺黑色腺瘤的優勢日益明顯,其創傷小,恢複快,感染發生率低,對柯興綜合征患者尤為適合[6],但術前必須將血壓、心率控製在穩定水平,以避免術中、術後腎上腺危象的發生。腹腔鏡腎上腺切除術既可經腹腔途徑,也可經腹膜後途徑,國內多選擇經腹膜後入路進行手術。目前國內外報道的腎上腺黑色素瘤經病理證實均為良性腫瘤,尚未發現治療後複發或轉移的病例報道,預後良好,多推薦保留腎上腺[7]。
[參考文獻]
[1] RosaiJ. 阿克曼外科病理學[M]. 回允中譯. 第8版. 沈陽:遼寧教育出版社,1999:1017-1018.
[2] Masatoyo Nakajo,Masayuki Nakajo,Yoriko Kajiya,et al. A black adrenal adenoma difficult to be differentiated from a malignant adrenal tumor by CT,MRI,scintigraphy and FDG PET/CT examinations[J]. Ann Nucl Medi,2011,25(10):812-817.
[3] Iwase K,Nagasaka A,Tsujimura T,et al. Cushing’ssyndrome with cortisol hypersecretion from one of bilateral adrenocortical adenomas: report of acase[J]. Surg Today,1994,24:538-543.
[4] Inomoto C,Sato H,Kanai G,et al. Black adrenal adenoma causing preclinical Cushing's syndrome[J]. Tokai J Exp Clin Med,2010,35(2):57-61.
[5] Langner C,Hoffmann J G,de Geeter P,et al. Pigmented pheochromocytoma. Case report with immunohistochemical and eledtron microscopic characte rization[J]. Pathologe,2001,22:276-280.
[6] 李偉,王躍東,楊進. Laparoscopic resection for a left adrenal black adenoma[J]. Chinese Medical Journal,2001,114:879-880.
[7] Young WF Jr,Thompson GB. Role for laparoscopic adrenalectomy in patients with Cushing’s sydrome[J]. Arq Bras Endocrinol Metabol,2007,51(8):1349-1354.
(收稿日期:2012-12-24)