篇名 | Clinical Evaluation and Management of Pheochromocytoma |
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卷期 | 4:3 |
並列篇名 | 嗜鉻細胞瘤之臨床評估及治療 |
作者 | 張進寶 、 陳明村 、 黃榮慶 、 陳光國 、 林登龍 、 李瀛輝 、 張延驊 、 吳宏豪 、 徐慧興 、 張心湜 |
頁次 | 1135-1141 |
關鍵字 | Phechromocytoma 、 paraganglioma 、 catecholamine 、 TSCI |
出刊日期 | 199309 |
嗜鉻細胞瘤是一罕見且會因高血壓而導致生命危險之疾病。其所引起之高血壓症狀可經外科手術而治癒;但因兒茶酚胺之釋放乃間歇性且病灶無固定位置,所以臨床上診斷較為困難。本院從1981年一月至1992年一月間共有26位嗜鉻細胞瘤患者;其中17位是男性,9位是女性。腫瘤位於腎上腺者有18位(69.2%)-3位(11.5%)病灶在兩側,1位(3.8%)家族性(MEA-II),2位(7.7%)惡性腫瘤病患;其餘8位患者(30.8%)其病灶不在腎上腺-二例在頸動脈體,一例在後縱隔腔,三例在上端上主動脈旁,一例在Zuckerkandl器官上,一例在膀胱內。臨床上主要症狀是高血壓;但是少數患者血壓正常甚至偏低。26位病患中,有8例(30.%)無高血壓病史。共計24位病患接受外科手術切除,有2位經證實為惡性嗜鉻細胞瘤,其中1位患者因多處轉移而死亡。結論:對於有尋常高血壓症狀之病患,應詳細檢查是否有嗜鉻細胞瘤存在之可能。應詳細檢查是否有嗜鉻細胞存在之可能。對於接受外科腫瘤切除後之病患,則需長期追蹤其療效。
Pheocharomocytoma is a rare and potentially lethal cause of hypertension, but it is surgically revesible. Diagnosis may be difficult, because catecholamine release is often intermittent and the location of the lesion is variable. Between January 1981 and January 1992, 26 patients with pheocharomocytoma were observed. There were 17 male and 9 female patients. The tumor was adrenal in 18 patients (69.2%), including bilateral in 3 (11.5%), familial (MEN-II) in 1 (3.8%) and malignant in 2 (7.7%). It was extra-adrenal in eight cases (30.8%), including carotid body in two cases, posterior mediastinum in one case, superior para-aortic in three cases, organs of Zuckerkandl in one case and urinary bladder in one case. The clinical hallmark was hypertension, but some patients were normotensive or hypotensive. Of the 26 patients, 8 (30%) had no history of hypertension. A total of 24 patients underwent surgical excision of the tumor. Two patients proved to have malignant tumors. Of these 2 patients, one case died of metastases. Unusual hypertensive syndrome should be screened for the possibility of pheochromocytoma. After surgical excision, long-term followup is mandatory.