患者女,43岁。半年前无意中发现左下腹有拳头大的包块,迅速增大伴左下肢麻木胀痛跛行2月。体查:心肺无异常,左中下腹部明显隆起,可扪及22×20cm大的包块,境界清,质地韧,无活动,无触痛;肝脾未扪及。妇科B超肿块非来自盆腔。小便常规正常,肝功能正常,BUN5.7mmoL/L。静脉肾盂造影,左输尿管下段向外移位,骨盆及左下肢X片无异常。术前诊断:腹膜后肿块性质待查。手术中见:肿块暗红色,分叶状,自腹膜后突向腹腔,左侧大小肠被推至右侧。肿块四周粘连致密;分离时易出血,术中输血1200ml,完整切除肿块,重1.75公斤。术后11天出院,出院时左腿跛行明显好转。病理诊断:神经母细胞瘤。 讨论:神经母细胞瘤又称成神经细胞瘤,(neuroblastoma)是起源于肾上腺髓质或交感神经链的一种恶性度极高的肿瘤,临床甚少见,且多见于幼儿。成人极罕见,据近10年的手头资料,国内尚未 The patient is 43 years old. Six months ago, he found a large fist mass in the left lower abdomen and quickly increased numbness in his left lower extremity in February. Physical examination: no abnormalities in heart and lung, the left middle and lower abdomen was obviously uplifted, and palpable 22 x 20 cm large mass, clear boundary, tough texture, no activity, no tenderness; liver and spleen are not palpable. Gynecologic B masses do not come from the pelvic cavity. Urinary regularity, normal liver function, BUN5.7mmoL/L. Intravenous pyelogram, the lower part of the left ureter was shifted outwards, and there was no abnormality in the pelvis and left lower extremities. Preoperative diagnosis: The nature of the retroperitoneal mass is unknown. During the operation, the tumor was dark red, lobulated, and bulging from the retroperitoneum to the abdomen. The left and right intestines were pushed to the right side. Adhesion was dense around the mass; blood was easily detached during separation, blood transfusion was performed during the operation, and 1200ml blood transfusion was performed. The mass was completely resected and weighed 1.75 kg. She was discharged on the 11th day after surgery and his left leg was significantly improved on discharge. Pathological diagnosis: neuroblastoma. Discussion: Neuroblastoma, also known as neuroblastoma, is a highly malignant tumor that originates in the adrenal medulla or sympathetic chain. It is rare in clinical practice and is more common in young children. Adults are extremely rare. According to the information of the past 10 years, the country has not yet