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沉默的乳腺红细胞瘤是一个未被认可的临床实体:来自一个大批量的上腺手术医院的结果
Meredith LaRue1, Constantine A Stratakis2, Alejandra Kalik3
1Department of Surgery, Hospital for Endocrine Surgery, HCA Healthcare, Tampa, FL, USA.
概括
偶发性静音染细胞瘤 (SPheo) 呈现异常,经常被误诊. 早期识别需要彻底的生化和成像评估,以便及时干预.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 手术病理学手术病理学
背景情况:
- 发红细胞瘤是一种罕见的上腺髓瘤.
- 偶发性静音细胞瘤 (SPheo) 缺乏经典的症状,并呈现出正常或轻微升高的生化指数.
- 诊断方面的挑战阻碍了及时识别和治疗SPheo.
研究的目的:
- 描述零星静音染细胞瘤 (SPheo) 的临床,生化,放射和病理特征.
- 为了提高SPheo的诊断准确性.
- 为了提高这种染细胞瘤亚型的临床识别.
主要方法:
- 对1273例上腺切除术 (2022年1月 - 2024年11月) 的回顾性分析.
- 鉴定出14名患者 (14.9%) 患有SPheo,基于缺乏经典症状和生化指数<2倍变化与上限值相比.
- 评估瘤大小,血/尿液中甲基氨酸,放射学解释和手术前诊断.
主要成果:
- SPheo瘤较小 (2.9厘米),生物化学指数明显较低 (1.22倍),与明显的色细胞瘤 (4.5厘米,11.32倍) 相比.
- 在SPheo中,血和尿液中甲基氨酸水平显著降低.
- 术前成像经常被误解 (腺瘤,不确定的,转移),42.8%的SPheo患者最初被诊断为轻度自主皮质醇分泌.
结论:
- 在高容量中心,SPheo 占 pheochromocytomas 的 14.9%.
- 非典型的呈现导致SPheo的频繁误诊.
- 综合评估和高临床怀疑对于准确的SPheo诊断和管理至关重要.
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