The clinical analysis of adrenal tumor combined with renal carcinoma in 42 patients / 中华内分泌代谢杂志

ABSTRACT

Objective To summarize the clinical characteristics of adrenal tumors combined with renal carcinoma and to extend the clinical understanding of the situation.Methods To analyze the data of 1 100 patients with adrenal tumors hospitalized in Peking University First Hospital from Jan.1994 to Mar.2012 retrospectively,in the series there were 42 combined with renal carcinoma.Results There were 27 males,15 females,aged 29 to 83 years,mean 60.5 years old.In 42 renal carcinomas,there were 29 (69.0％) clear cell carcinomas,5 (11.9 ％) cystic renal carcinomas,2 (4.8％)clear cell with granulosa cell hybrid carcinomas,1 renal lymphoma,1 (2.4％) spindle cell tumor,1 acidophilic cell adenoma,and 1 undifferentiated type of renal cell carcinoma and pathologically not clear in 2 cases (4.8％).Clinical manifestations were not specific.In 42 adrenal tumors,20 situated in the left,and 17 right,and 5 were bilateral.35 cases were considered primary adrenal tumors,in which 3 were diagnosed primary hyperaldosteronism,32 were non-functional tumors.Other 7 were non-functional matastatic carcinomas.25 patients underwent resection of adrenal tumors,and pathology revealed 22 (88.0％) were primary,in which 12 (54.6％) were cortical adenomas,7 (31.9％) hyperplasia,1 (4.5 ％) pheochromocytoma,1 (4.5 ％) ganglioneuroma,1 (4.5 ％)adenoma with hyperplasia;2 (8.0％)metastatic tumors,and 1 (4.0％) non-Hodgkin' s lymphoma.The mean diameter of primary adrenal tumors was 1.9 cm,while that of metastatic carcinoma was 3.84 cm.25 underwent abdominal ultrasonography,40 underwent computed tomography (CT) scan,6 underwent magnetic resonance imaging (MRI) scan,positive rate was 72.0％,97.5％,and 100.0％ respectively.25 patients who underwent surgery were followed up,17 survived for 8 months-6 years,4 died,in which 1 metastatic carcinoma died of intraoperative bleeding,1 died of adrenal lymphoma,2 died because of other disease,4 were lost to follow-up.Conclusions The most common type of renal carcinoma combined with adrenal tumors was clear cell carcinoma,while majority of the adrenal tumors were primary with non-specific clinical manifestations and function.The adrenal tumors might be located in the same or the opposite side of renal carcinoma,also might be bilateral which were more common in metastatic carcinomas and always bigger than primary ones.CT/MRI scans were important in judging the nature of the tumors and pathology was the gold standard.The non-functioning primary adrenal tumors could be safely followed up,and the isolated metastatic carcinoma should be resected.Prognosis depends mainly on that of renal carcinoma.