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目的 总结肾上腺皮质腺癌的诊治经验。 方法 分析 12例肾上腺皮质腺癌的临床特点、病理学特征及治疗预后情况。男 6例 ,女 6例。平均年龄 37岁。肿瘤均为单发 ,右侧 10例 ,左侧 2例 ;直径 3～ 30cm。Sullivan分期 :Ⅰ期 3例 ,Ⅱ期 3例 ,Ⅲ期 2例 ,Ⅳ期 4例。功能性肿瘤 4例 ,无功能性肿瘤 8例。 结果 11例患者完整切除肿瘤 ,1例有骨转移者因肿瘤巨大 ,周围浸润 ,仅行活检。标本雌激素受体 (ER)测定 7例 ,阳性 5例。 5例分别于术后 6～ 18个月死亡 ;7例仍健康存活 ,其中 5例服用三苯氧胺。 结论 肾上腺皮质腺癌可能属性激素依赖性肿瘤 ,三苯氧胺是较有效的辅助治疗药物 ,肿瘤分期、肿瘤大小与预后密切相关。
Objective To summarize the experience of diagnosis and treatment of adrenal cortical adenocarcinoma. Methods The clinical features, pathological features and prognosis of 12 cases of adrenal cortical adenocarcinoma were analyzed. There were 6 males and 6 females. The average age is 37 years old. The tumors were single, with 10 cases on the right side and 2 cases on the left side. The diameter was 3-30cm. Sullivan staging: 3 cases of stage I, 3 cases of stage II, 2 cases of stage III, and 4 cases of stage IV. There were 4 functional tumors and 8 non-functional tumors. Results 11 patients underwent complete resection of the tumor. One patient with bone metastasis had a large tumor with peripheral infiltration. Only biopsy was performed. Specimens estrogen receptor (ER) were measured in 7 cases and positive in 5 cases. Five patients died 6 to 18 months after surgery. Seven patients remained healthy and five of them received tamoxifen. Conclusion Adrenocortical adenocarcinoma may be a hormone-dependent tumor, and tamoxifen is an effective adjuvant therapy. Tumor staging, tumor size, and prognosis are closely related.