The Diagnosis And Treatment Of Adrenocortical Oncocytoma(Report Of 6 Cases)

Background:Disease of adrenal gland is one of frequent diseases in Urology,including adrenal cortex diseases(Cushing syndrome,Aldosterone syndrome,other adrenal glands excreting hormone ) and adrenal medulla diseases(pheochromocytoma,adrenal medulla cell proliferation syndrome ).Because of the improving diagnostic method,rare tumors in adrenal gland are much easily found than before,most of which are nonfunctional without any clinical manifestation.Some of them may cause hypertension,central obesity,hairiness.The adrenocortical oncocytoma is one of the rare tumors in Urology. About 50-60 cases were reported in abroad as well as some single cases in our country. With the improving diagnostic technology,cases are much easily detected than before. In following words,we try to argue the epidemiology,epidemiology,clinical manifestation and treatment of the adrenocortical oncocytoma.,especially in differential diagnosis with the malignant tumors.It affects the quality of life and survival time.Methods:1.Cases and exclusion criteria included:1.1 Included standards:It's mainly rely on pathology,.Oncocytomas are histologically characterized by cells with eosinophilic granular cytoplasm and with the presence of numerous closely packed mitochondria ultrastructurally.1.2 The exclusion criteria:All other tumors are pathologically indicated not oncocytoma. 2.Case collectionCollected from October 2002 to September 2006,a total of 6 cases are included with a detailed record of the name,gender,age,home address,telephone number,diagnosis, the merger disease,operative methods,date of surgery,amount of bleeding, postoperative complications,and postoperative analgesic use,days of intravenous antibiotics,the hospitalization time after operative,paraffin section,HE stain, immunohistochemistry,light microscope are involved in tumor diagnosis.And we review articles about 50 adrenal oncocytoma cases.Results:One patient had hypertension 2 years before.,with the highest blood pressure 180/100mg,ambiguity sight,dizziness and with skin pigmentation around eyes.The body weight increased 10kg.Another patient became aching pain in kidney region, aggravation after work as well as nausea.All other patients were detected in physical examination.All of the cases were successfully removed successfully by abdominoscope. The operation time was 65-175min,95.8min average,no intraoperative blood transfusion.The mass volume is multiple from the biggest of 5.0 cm×6.0cm×6.0cm to the smallest of 1.5cm×1.2cm×0.8cm.One case had blood transfusion after operation because of the capillary hemorrhage in wound..the group were cured and discharged, the hospitalization time lasts 8-14 days.All the pathological reports were oncocytomas. We follow-up 3-6years,without finding any recurrence.Conclusion:Adrenocortical oncocytomas are mostly found in physical examination,with rarely Cushing syndrome manifestation..The diagnosis mainly rely on pathology. Oncocytomas are histologically characterized by cells with eosinophilic granular cytoplasm and numerous closely packed mitochondria ultrastructurally.