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Андрология и генитальная хирургия. 2016; 17: 38-43

Хирургическое лечение больных опухолями надпочечников

Толкачев А. О., Мурадян А. Г., Воробьев Н. В., Костин А. А., Попов С. В.

https://doi.org/10.17650/2070-9781-2016-17-4-38-43

Аннотация

Для оценки характера поражения надпочечников применяют компьютерную томографию, магнитно-резонансную томографию, позитронно-эмиссионную томографию, совмещенную с компьютерной томографией с 18F-фтордезоксиглюкозой, в некоторых случаях используют сцинтиграфию 123I метайодбензилгуанидином. Злокачественные опухоли надпочечников, такие как адренокортикальный рак и злокачественная феохромоцитома, имеют особо агрессивное течение, обусловливающее высокую летальность у данной категории пациентов, особенно на поздних стадиях заболевания. В связи с этим существует статистически значимая разница в выживаемости больных в зависимости от сроков выявления заболевания и начала терапии. В статье представлен анализ результатов хирургического лечения пациентов с опухолями надпочечников.

Список литературы

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Andrology and Genital Surgery. 2016; 17: 38-43

Surgical treatment of adrenal tumors

Tolkachev A. O., Muradyan A. G., Vorobyov N. V., Kostin A. A., Popov S. V.

https://doi.org/10.17650/2070-9781-2016-17-4-38-43

Abstract

The following methods are usually used for evaluation of adrenal lesion: computed tomography, magnetic resonance imaging, 18F-fluorodeoxyglucose positron emission tomography/computed tomography and sometimes 123I-meta-iodobenzylguanidine scintigraphy. Malignant adrenal tumors, such as adrenocortical carcinoma and malignant pheochromocytoma, appear to have particularly aggressive course, which leads to high mortality rate among these patients, especially in the later stages of the disease. Thus, there is a statistically significant difference in patients’ survival depending on time to diagnosis and time to therapy initiation. In this article we analyze the results of surgical treatment in patients with adrenal tumors

References

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2. Kassi E., Kaltsas G., Zografos G. N., Chrousos G. Current issues in the diagnosis and management of adrenocortical carcinomas. Expert Rev Endocrinol Metab 2010;5:451–66.

3. Barzon L., Sonino N., Fallo F. et al. Prevalence and natural history of adrenal incidentalomas. Eur J Endocrinol 2003:149:273–85.

4. Kloos R. T., Gross M. D., Francis I. R. et al. Incidentally discovered adrenal masses. Endocr Rev 1995:16:460–84.

5. Mansmann G., Lau J., Balk E. et al. The clinically inapparent adrenal mass: update in diagnosis and management. Endocr Rev 2004:25:309–40.

6. Fassnacht M., Libé R., Kroiss M. et al. Adrenocortical carcinoma: a clinician’s update. Nat Rev Endocrinol 2011;7(6):323–35. DOI: 10.1038/nrendo. 2010.235.

7. Pacak K., Eisenhofer G., Ahlman H. et al. International symposium on pheochromocytoma. Pheochromocytoma: recommendations for clinical practice from the first international symposium. October 2005. Nat Clin Pract Endocrinol Metab 2007;3(2):92–102.

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17. Kimura N., Watanabe T., Noshiro T. et al. Histological grading of adrenal and extraadrenal pheochromocytomas and relationship to prognosis: a clinicopathological analysis of 116 adrenal pheochromocytomas and 30 extra-adrenal sympathetic paragangliomas including 38 malignant tumors. Endocr Pathol 2005; Spring16(1):23–32.

18. Weiss L. M. Comparative histologic study of 43 metastasizing and nonmetastasizing adrenocortical tumors. Am J Surg Pathol 1984;8:163–9.

19. van Slooten H., Schaberg A., Smeenk D., Moolenaar A. J. Morphologic characteristics of benign and malignant adrenocortical tumors. Cancer 1985;55: 766–73.

20. Aubert S., Wacrenier A., Leroy X. et al. Weiss system revisited: a clinicopathologic and immunohistochemical study of 49 adrenocortical tumors. Am J Surg Pathol 2002;26(12):1612–9.

21. Van’t Sant H. P., Bouvy N. D., Kazemier G. et al. The prognostic value of two different histopathological scoring systems for adrenocortical carcinomas. Histopathology 2007;51(2):239–45.

22. Zografos G. N., Kothonidis K., Ageli C. et al. Laparoscopic resection of large adrenal ganglioneuroma. JSLS 2007;11: 487–92.

23. Miller B. S., Gauger P. G., Hammer G. D., Doherty G. M. Resection of adrenocortical carcinoma is less complete and local recurrence occurs sooner and more often after laparoscopic adrenalectomy than after open adrenalectomy. Surgery 2012;152(6):1150–7. DOI: 10.1016/j. surg. 2012.08.024.

24. Cooper A. B., Habra M. A., Grubbs E. G. et al. Does laparoscopic adrenalectomy jeopardize oncologic outcomes for patients with adrenocortical carcinoma? Surg Endosc 2013;27(11):4026–32. DOI: 10.1007/s00464-013-3034-0.

25. Zeiger M., Thompson G., Duh Q.-Y. et al. American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons Medical Guidelines for the Management of Adrenal Incidentalomas. Endocr Pract 2009; 15(Suppl 1):1–20.