Clinical Diagnosis And Treatment Analysis For Bilateral Adrenal Tumor In211Cases

Objective: to summarize the pathologic feature of bilateral adrenal tumors, andto investigate the clinical diagnosis and treatment of bilateral adrenal tumors.Methods:Retrospective analysis of211patients with bilateral adrenal tumor in4threetertiary hospital (the First and the Second Affiliated Hospital of Dalian MedicalUniversity, The Central Hospital of Dalian and Dalian Friendship Hospital) of theCity of Dalian in Liaoning Province,. There were162males (76.8%), female49cases(23.2%). The average age was48.3years (16-83years). Bilateral primary adrenaltumor in112cases (53%) with99cases of secondary tumor (47%). In the bilateralprimary adrenal tumors, sebaceous adenoma in69cases (account for bilateral primarytumor in61.6%), of which,19cases of bilateral adrenal cortical adenoma;5cases ofpheochromocytoma (4.5%of bilateral primary tumor),4cases in which bilateralpheochromocytoma; bilateral secondary tumor (Metastatic carcinoma) in99cases(account for47%), of which,95cases of bilateral metastatic tumor; we focus onbilateral adrenal adenoma, pheochromocytoma and bilateral metastatic tumor relatedsymptoms and signs, laboratory examination, imaging findings, preoperativepreparation and the measures of operation, postoperative performance with adrenallow function and other aspects of the summary and research, to explore the bestoption clinical diagnosis and treatment.Results:Having collected211cases of patients with bilateral adrenal tumors,adrenal primary tumor112cases (53.0%) slightly more than99cases of secondarytumors (47.0%). More than162cases of males and49females, aged middle-aged. Among them, the number of sebaceous bilateral adrenal tumors up to19cases,bilateral pheochromocytoma4cases. Secondary tumors,56cases of lung cancer,accounting for secondary adrenal tumors56%, of which the transfer of patients withsquamous cell carcinoma accounts for18cases of lung metastases topped32.1%.19cases of pathological outcomes for patients with bilateral adrenal adenoma,9casessurgical patients over the same period, the average operative time120min, averageblood loss180ml, the average length of stay10.5days better than staging surgery onlength of stay and cost;9patients with the same period of surgery, seven cases oflaparoscopic surgery mean time120min, average blood loss175ml, the averagelength of stay12.5days better than open surgery, the disadvantage is that therelatively high cost of hospitalization.Bilateral pheochromocytoma patients havetypical clinical manifestations. The tumor diameter is large, ranging from1.8-10.2cm,1routine staging operation; operation3cases, the time of operation is200-350min,the amount of bleeding is250-550ml,18-30days, hospitalization time, intraoperativeblood pressure fluctuations, systolic blood pressure greater than200mmHg2cases,and postoperative complications of1cases of adrenal gland.Bilateral metastaticlesions average diameter of4.3cm, but the size differences, not smooth foci of59cases, accounting for61.5%of cancer metastasis; edge is not smooth for the54cases,56.2%; tumor inside uneven density of11cases,11.5%;67cases of tumorsurrounding tissue have different degrees of invasion and infiltration; enhanced CTvalue-29-53HU, enhanced CT is15-68HU.Conclusion:Bilateral adrenal tumors with higher incidence in the people ofmale and middle-aged, pathological type for bilateral primary adrenal tumor withcortical adenoma is the most common; bilateral secondary adrenal tumor in lungsquamous cell carcinoma is the most frequent，it is a safe and reliable method ofbilateral adrenal adenoma for resection with the both by laparoscope at the sametime，while，bilateral pheochromocytoma patients undergoing open transabdominalapproach of operation with both side in the same time is appropriate.With the certainimaging features of bilateral metastasis adrenal tumors, it can assist the Department ofUrology physicians to identify and diagnosis in clinical.