摘要
目的:提高对膀胱嗜铬细胞瘤的诊断和治疗水平。方法:回顾性分析13例膀胱嗜铬细胞瘤的临床和病理资料,并结合文献复习进行讨论。结果:13例患者中,高血压患者6例,其中5例在排尿时典型发作;间歇性肉眼血尿4例。术前确诊5例。13例均行手术治疗,9例行膀胱部分切除术,2例行膀胱部分切除和输尿管再植术,1例行TURBT术,1例行TURBT后中转开放性膀胱部分切除术。13例均经术后病理检查及免疫组化证实为膀胱嗜铬细胞瘤,其中9例患者获得3～11年随访,1例患者术后6年死于肝转移。结论:与排尿有关的阵发性高血压发作,头痛头晕为膀胱嗜铬细胞瘤的典型表现,可应用B超、CT、MRI、^(123)I-MIBG作定位诊断,尿VMA和儿茶酚胺作定性诊断。手术切除是首选治疗方法,术后应严格随访。
Objective： To evaluate the aroaches for diagnosis and treatment of pheochromocytoma in urinary bladder. Methods： 13 cases of bladder pheochromocytoma were included. Hypertension was observed in 6 cases,of whom 5 had paroxysmal hypertension during urination. Intermittent macrohematuria was found in 4 cases. Five cases were preoperatively suspected of having bladder pheochromoeytoma. 13cases all received operation. 11 cases were removal of the partial bladder and two bladder pheochromoeytoma of them added ureter replantation. 1case were TUR-BT. Another case was removal of the partial after TUR-BT. Results：During the 3 to 11 years follow-up , one patient suffered from metastatic tumor 6 years after initial operation and this case was confirmed as malignant pheochromocytoma. The other cases had normal blood pressureand no recurrent tumor developed. Conclusions： The typical compsite symptoms of bladder pheochromoeytoma consist of intermittent macro hematuria, hypertension and paroxysmal occurrence during mieturition. B-ultrasound, CT, MRI and 123I-MIBG scintigraphy have higher value in localizing the lesions. Urinary VMA and catecholamine detection is useful in quatitative diagnosis. Surgical excision of the tumor is the referred management and close follow--up after surgery.
出处
《临床泌尿外科杂志》
北大核心
2011年第12期916-918,共3页
Journal of Clinical Urology
关键词
膀胱肿瘤
嗜铬细胞瘤
诊断
病理学
bladder neoplasm
pheochromocytoma
diagnosis
pathology
