肾上腺皮质腺癌的诊断与治疗

目的 总结肾上腺皮质腺癌（ACC）的诊治经验,提高肾上腺皮质癌的诊治水平.方法 对5例ACC患者的临床表现、实验室及影像学检查、治疗和预后进行回顾性分析.结果 本组B超示肾上腺实质性中等回声,内部回声不均匀,可见点状血流反射;CT均示肿瘤边缘模糊,CT值32 ～ 65 HU,强化不均匀;MRI示肿瘤边界欠清,T2加权片上2例呈高信号,1例呈高低混杂信号,病灶中心坏死区无明显强化.5例均行开放性手术完全切除肿物,术后应用米托坦2例、放疗1例;术后随访6 ～ 36个月,平均生存23个月.结论 B超、CT等检查有利于ACC的早期诊断,手术切除是治疗ACC的有效方法.

Diagnosis and treatment of adrenocortical carcinoma

Objective To conclude the diagnosis and treatment experience of adrenocortical carcinoma （ACC） and to improve the treatment level of ACC. Methods The clinical manifestations, laboratory and imaging examinations, treat- ment and prognosis of 5 patients were analyzed retrospectively. Results Type-B ultrasonic of this group showed parenchy- matous medium echo in the adrenal glands, uneven internal echo and visible punetiform blood stream reflex. CT all indica- ted the unsharp edge, CT value as 32-65 HU and uneven enhancement. MRI showed vague boundary, 2 cases of hyperin- tense and 1 case of low-high signal on T2 weighted images, and it also showed necrotic areas of lesion center were not signif- icant enhanced. Five cases underwent open operation to completely remove the tumor. After surgery, 2 cases was treated by mitotane and 1 case received radiotherapy. They were followed up for 6-36 months, and the mean survival time was 23 months. Conclusion Type-B ultrasonic, CT and other tests can help the early diagnosis of ACC. Surgery is considered to be the effective way to cure ACC.