DOI: https://doi.org/10.22141/2224-0721.14.8.2018.154856

The particularities of management of patients with malignant tumors of adrenal medulla

A.N. Kvachenyuk, D.A. Kvachenyuk

Abstract


Pheochromoblastoma is a tumor developing from adrenal medulla and characterizing the severe course and high mortality level (15 %). Its severity is due to presence of not only malignancy but also catecholamine hyperproduction. The authors analysed the results of surgical treatment of 60 patients with pheochromoblastoma who were treated in surgical clinic in 1968–2017. The most effective method of treatment is surgery. The method of choice is a lumbotomic extraperitoneal access. The oncological radicality demands the complete tumor removal in a single capsule with the adrenal gland and revision of paranephric, paracaval and paraaortal tissues. Thirty eight (63.3 %) of 60 patients had 38 radical surgical procedures with following long-term remission. Three (5 %) patients had disease remission only after repeated surgery. Two patients live with the disease persistence, the drug ma­nagement of which is easier than before surgery. Eight (13.3 %) patients had widespread metastatic process and they were referred for the symptomatic treatment. The recurrence after the primary surgery is a poor prognostic factor. The majority of patients (55.8 %) with the recurrence were incurable. In the rest of the cases, the operative treatment led to the long-term remission only in 71.9 % patients.

Keywords


malignant tumors; pheochromoblastoma; adrenal glands; diagnosis; surgical treatment

References


Komisarenko IV, Rybakov SI, Kvacheniuk AN. Surgical treatment of malignant tumours of adrenal glands. Surgery of Ukraine. 2005;(13):53-57. (in Russian).

Werbel SS, Ober KP. Pheochromocytoma. Pheochromocytoma. Update on diagnosis, localization, and management. Med Clin North Am. 1995 Jan;79(1):131-53.

Bewnn DE, Gimenez-Roqueplo AP, Reilly JR, et al. Clinical presentation and penetrance of pheochromocytoma/paraganglioma syndromes. J Clin Endocrinol Metab. 2006 Mar;91(3):827-36. doi: 10.1210/jc.2005-1862.

Komisarenko IV, Rybakov SI, Kvacheniuk AN. Classification of malignant adrenal tumours. Klinicheskaia khirurgiia. 2004;(9):25-27. (in Russian).

Young WF Jr. Clinical practice: the incidentally discovered adrenal mass. N Engl J Med. 2007 Feb 8;356(6):601-10. doi: 10.1056/NEJMcp065470.

Ilias I, Pacak K. Current approaches and recommended algorithm for the diagnostic localization of pheochromocytoma. J Clin Endocrinol Metab. 2004 Feb;89(2):479-91. doi: 10.1210/jc.2003-031091.

Yu L, Fleckman AM, Chadha M, Sacks E, Levetan C. Radiation therapy of metastatic pheochromocytoma: case report and review of the literature. Am J Clin Oncol. 1996 Aug;19(4):389-93.

Bouloux PM, Fakeeh M. Short‐term fasting in obesity fails to restore the blunted GH responsiveness to GH‐releasing hormone alone or combined with arginine. Clin Endocrinol. 1995;43(6):657-664. doi: 10.1111/j.1365-2265.1995.tb00531.x

Kim HY, Kim SG, Lee KW, et al. Clinical study of adrenal incidentaloma in Korea. Korean J Intern Med. 2005 Dec;20(4):303-9.

Kvacheniuk AN. Adrenal surgery: global advances in Ukraine. Zdorov’ja Ukrai'ny. 2011;(270):28. (in Russian).

Loh KC, Shlossberg AH, Abbott EC, Salisbury SR, Tan MH. Pheochromocytoma: a ten year survey. QJM. 1997 Jan;90(1):51-60.

Abasheva SN, Alekseev BM, Artemchuk, LV, et al, authors; Faksh VA, editor. Laboratornyi spravochnik SINEVO [Synevo Laboratory reference book]. Kyiv; 2015. 870 p. (in Russian).




Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© "Publishing House "Zaslavsky", 1997-2018

 

   Seo анализ сайта