Dissertation > Excellent graduate degree dissertation topics show

Diagnosis and Management of Paraganglioma: An Analysis of 106 Cases

Author: XuWeiFeng
Tutor: LiHanZhong
School: Peking Union Medical College , China
Course: Department of Urology
Keywords: Paraganglioma Laparoscopic Malignant
CLC: R730.5
Type: Master's thesis
Year: 2008
Downloads: 114
Quote: 0
Read: Download Dissertation


Objective To improve the diagnosis and treatment of paraganglioma. Materials and Methods Union Medical College Hospital from 1986 to 2007, 106 patients were treated paraganglioma cases were analyzed retrospectively. Male 51 cases, female 55 cases. Age of onset is 13-73 years, mean 38.8 ± 14.16 years. Tumor: 87 cases of retroperitoneal bladder seven cases, mediastinum, the seven cases, four cases of cardiac, liver. Single tumor 85 cases, 21 cases of multiple tumors. Tumor diameter of 1.5-22cm, an average of 6.55 ± 3.22cm. 82 cases of treatment of hypertension and related symptoms, physical examination, or other symptoms of treatment 24 cases. 92 cases underwent 24-hour urinary catecholamine check: the elevated norepinephrine 78 cases (85%), epinephrine increased in 57 cases (61%). 3 times higher than normal catecholamine levels that mainly to the secretion of the hormone, 72 patients (78%) patients with norepinephrine secretion. MIBG check the 46 cases were positive in 37 cases (80.5%). Line octreotide check the 32 cases were positive in 26 cases (81%). MIBG negative 9 routine the octreotide checks, 7 cases were positive. 96 routine enhanced CT examination, in addition to two cases of cardiac tumors, lesions were found. MRI of 49 patients, lesions were found. The results of surgical treatment of 99 patients, 7 patients without surgery. Operation group to remove the tumor, 84 cases of open surgery, 15 cases of laparoscopic surgery. Cardiac paraganglioma four cases are completed in cardiopulmonary bypass conditions, patients need coronary artery bypass surgery. The open surgery time 70-380min, the average 115min bleeding 200-2400ml, an average of 362 ± 133 ml of. 18 patients required blood transfusion, blood transfusion 400 ~ 1800ml, average 600ml. Laparoscopic surgery time 50-230min, an average of 92 ± 37min. Bleeding 50-320ml, 103 ± 61ml, no blood transfusion. Three cases of postoperative complications of pneumonia, deep vein thrombosis in 1 case, and 1 died. Pathological are paraganglioma. Vicious 34 cases: 17 cases of capsular invasion, two cases of intravascular visible tumor thrombus, nine cases of lymph node metastasis, bone metastasis in 5 cases, lung metastases patients. 6-134 months, with an average follow-up follow-up time of 57 months. Recurrence in 21 cases (21.2%), 7 died, four patients died of metastasis, 1 patient died of heart disease, ominous reason two cases. Four cases diagnosed as benign after 23 to 117 months of follow-up found that tumor metastasis. Conclusion paraganglioma occur in the peritoneum, and adrenal pheochromocytoma compared easily prone to recur, malignant high incidence. 24-hour urinary catecholamine determination of sensitivity and specificity were higher qualitative diagnosis. The enhanced CT high sensitivity, can be used as first-line positioning of diagnostic tests. The MIBG check qualitative and positioning diagnostic role, particularly in multiple tumors, recurrent tumors, tumor metastases diagnosis is superior to CT, MRI examination. Surgery is the only cure treatment be satisfied with the therapeutic effect of laparoscopic surgery. Pathological examination can not be as benign and malignant diagnosis is based on a long time close follow-up is necessary.

Related Dissertations

  1. Effects of the Therapeutic Communication System Intervention on the Postoperative Gynecological Malignant Tumor Patients with Depression,R473.73
  2. Analysis of Effect of cook Wire on Treatment of Infertility Caused by Fallopian Tube Factors with Hysteroscope Association Laparoscope,R713
  3. Analyzing Complications of 47 Cases of Laparoscopic Gynecologic Surgery,R713
  4. Clinical Study on Effect of Xie Shi Lung Cancer NO.2 in Malignant Pleural Effusion of Lung Cancer,R734.2
  5. Laparoscopic versus open surgery for early stage endometrial cancer clinical comparative analysis,R737.33
  6. No pigmented malignant melanoma one case and review of literature,R739.5
  7. Expression of TrkB in Malignant Melanoma and the Effects of Triptolide on Its Expression,R739.5
  8. The Significance of Cytological Examination of Free Cancer Cell and Expression of CK20 mRNA in the Peritoneal Cavity Washes of Laparoscopic Colorectal Resction Patients,R735.3
  9. The Clinical Analysis of Retroperitoneal Laparoscopic Dismembered Pyeloplasty with Different Technique of JJ Stenting in Children,R726.9
  10. Exploration of High-risk Factors of Ectopic Pregnancy in Vitro Fertilization and Embryo Transfer,R714.8
  11. Clinical Efficacy of Triptorel Combined with Laparoscopic Surgery for Endometriosis,R713
  12. The Clinical Applied Merit and Analysis of Associated Complication of Laparoscopic Surgery in Gynecology,R713
  13. The Influence of Different Dosage of Remifentanil on Postoperative Pain and Dose-response Relationship of Tramadol for Inhibiting Remifentanil-induced Hyperalgesia,R614
  14. Cost-effectiveness Analysis on Addition of a New Sedative and Analgesic Drug Dexmedetomidine Hydrochloride to General Anesthesia Program,R614
  15. Effects of Clinical Pathways in Laparoscopic Cholecystectomy: a Meta-analysis,R657.4
  16. Laparoscopic Excision of Adult Choledochal Cyst, and Clinical Analysis in Two Cases,R657.4
  17. Clinical Effect Analysis of Laparoscopic Hepatic Left Lateral Lobectomy for Hepatic Bile Duct Stones,R657.4
  18. Risk Factors and Management of Recurrent Bile Duct Stones after EST,R657.4
  19. The Long-term Follow-up Study on Multiple Mini-invasive Surgical Treatment for Extrahepatic Bile Duce Stones.,R657.4
  20. Comparative Study Between Transumbilical Single-hole Miniature Endoscopic Cholecystectomy and Conventional Laparoscopic Cholecystectomy,R657.4
  21. The Evaluation of Xiao Gu Fang Jointing Cisplatin with Treat of Cancer Nature Ascites,R730.5

CLC: > Medicine, health > Oncology > General issues > Tumor Therapy
© 2012 www.DissertationTopic.Net  Mobile