The Study And Analysis Of Clinical Features,diagnosis And Treatment Of Adrenal Neuroendocrine Carcinoma

ObjectThe adrenal gland is one of the endocrine organs of human body.There is one on each side,weighing about 15 g in total.Hormones that the adrenal gland secretes can affect blood pressure,heart rate and physiological metabolism,which have a great influence on body function.With the further development of study,the diseases of adrenal gland have been paid more and more attention to in recent years.As a type of adrenal tumor,adrenal neuroendocrine carcinoma is rarely seen in clinical practice.However,it is extremely malignant and has high mortality rate.Patients often get advanced disease at diagnosis and miss the optimal treatment time.This study summarized the clinical data of patients with adrenal neuroendocrine carcinoma in our hospital.We also conducted a detailed statistical comparison of the disease characteristics,clinical manifestations and treatment methods,summing up the characteristics of the disease in order to foster a better understanding of it in the future and finally find out the optimal treatment to relieve the sufferings of patients.MethodsFrom October 2011 to September 2017,15 cases of patients were reviewed and their data were analyzed retrospectively,with 9 males and 6 females,aged 2-77 years old.The average age is(61.2±12.6)years old.ResultsAll 15 patients had definite pathological or biopsy results.7 cases received laparoscopic adrenal grand radical resection.The other 8 had metastases of different degree according to preoperative examination.Among the 8 cases who had metastases,3 cases and 1 case underwent chemotherapy and radiotherapy respectively.2 cases were treated with interventional embolization.The 2 cases left received conservative treatment.Immunohistochemical staining was positive in Syn(80%,12/15),NSE(73.3%,11/15),CgA(53.3%,8/15),CD56(73.3%,11/15)and EMA(46.7%,7/15).The follow-up data were available in 12 cases(1~50 months,with 11.5 months as the median).2 cases survived 48 months and 50 months respectively without relapse and metastases after adrenal gland radical cystectomy.1case who suffered from liver metastasis after radical cystectomy received radiotherapy and survived 15 months till now.1 case was diagnosed with adrenal neuroendocrine carcinoma,accompanied by multiple liver metastases and that patient has been living for 19 months after being treated with interventional embolization and hepatic radiofrequency ablation.The remaining 8 cases were dead ones whose average survival time is(8.6±4.7)months.ConclusionAdrenal neuroendocrine carcinoma is a kind of rare malignant tumor with an extremely poor prognosis.The gold standard for diagnosis is pathology.Adrenal gland radical cystectomy is the first choice for early treatment.Chemotherapy,radiotherapy and interventional embolization for late treatment do good to prolonging the overall survival time of patients.