Zhonghua yi xue za zhi · 2011
[Diagnosis and treatment for adrenal ganglioneuroma].
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Huang Zhong-Ming, Li Han-Zhong, Xiao He, Ji Zhi-Gang
Аннотация
OBJECTIVE: To evaluate the clinical characteristics,diagnosis and treatment for adrenal ganglioneuroma.
METHODS: Thirty cases of adrenal ganglioneuroma at our hospital from 1999 to 2010 were reviewed. Their clinical, radiological, laboratory and pathologic findings as well as follow-up data were analyzed retrospectively.
RESULTS: There were 12 males and 18 females with an age range of 7 - 63 (23.8 ± 11.4) years old. Tumor size ranged from 2.5 cm to 15 cm. Fourteen (46.7%) cases were found incidentally without any overt symptom. And the presenting symptoms and signs of the others were paroxysmal headache and palpitation (n = 7, 23.3%), hypertension (n = 5, 16.7%) and flank or abdominal pain (n = 4, 13.3%). All cases underwent open or laproscopic operations and their diagnosis of adrenal ganglioneuroma was confirmed pathologically. An oval or crescentic well-defined mass, low or intermediate attenuation on CT (computed tomography) scan was found in most cases. Tumors partially or completely surrounded major blood vessels in 9 cases while 7 cases had discrete punctuate calcification. The 24-hours urinary catecholamine and urinary free cortisol output were within a normal range. Seventeen cases underwent a (99)Tc-octreotide scan and negative results were found in 15 cases. Seven cases had a (131)I-Metaiodobenzylguanidine ((131)I-MIBG) scan and all results were negative. Twenty-one cases were diagnosed empirically as adrenal ganglioneuroma. One case was found pre-operatively with multiple bone metastases. Among all cases, either open operation (n = 11) or retroperitoneal laparoscopic excision (n = 19) was performed successfully. All recovered smoothly. One patient with pre-operative bone metastasis developed progression. No recurrence was detected after a follow-up period of 1 - 11 years.
CONCLUSION: Mostly benign in nature, adrenal ganglioneuromas is often found incidentally without specific clinic symptoms. A relatively accurate preoperative diagnosis can be made on the basis of a detailed history and the relevant imaging and laboratory results. Surgical resection of tumor is a preferred choice with a fairy good prognosis.
METHODS: Thirty cases of adrenal ganglioneuroma at our hospital from 1999 to 2010 were reviewed. Their clinical, radiological, laboratory and pathologic findings as well as follow-up data were analyzed retrospectively.
RESULTS: There were 12 males and 18 females with an age range of 7 - 63 (23.8 ± 11.4) years old. Tumor size ranged from 2.5 cm to 15 cm. Fourteen (46.7%) cases were found incidentally without any overt symptom. And the presenting symptoms and signs of the others were paroxysmal headache and palpitation (n = 7, 23.3%), hypertension (n = 5, 16.7%) and flank or abdominal pain (n = 4, 13.3%). All cases underwent open or laproscopic operations and their diagnosis of adrenal ganglioneuroma was confirmed pathologically. An oval or crescentic well-defined mass, low or intermediate attenuation on CT (computed tomography) scan was found in most cases. Tumors partially or completely surrounded major blood vessels in 9 cases while 7 cases had discrete punctuate calcification. The 24-hours urinary catecholamine and urinary free cortisol output were within a normal range. Seventeen cases underwent a (99)Tc-octreotide scan and negative results were found in 15 cases. Seven cases had a (131)I-Metaiodobenzylguanidine ((131)I-MIBG) scan and all results were negative. Twenty-one cases were diagnosed empirically as adrenal ganglioneuroma. One case was found pre-operatively with multiple bone metastases. Among all cases, either open operation (n = 11) or retroperitoneal laparoscopic excision (n = 19) was performed successfully. All recovered smoothly. One patient with pre-operative bone metastasis developed progression. No recurrence was detected after a follow-up period of 1 - 11 years.
CONCLUSION: Mostly benign in nature, adrenal ganglioneuromas is often found incidentally without specific clinic symptoms. A relatively accurate preoperative diagnosis can be made on the basis of a detailed history and the relevant imaging and laboratory results. Surgical resection of tumor is a preferred choice with a fairy good prognosis.