McLaughlin S A, Schmitt T M, Huguet K L, Menke D M, Nguyen J H
Department of General Surgery, Mayo Clinic Jacksonville, Jacksonville, Florida 32224, USA.
Am Surg. 2005 Mar;71(3):191-3.
Adrenal masses have varying presentations. Most commonly, adrenal masses are discovered incidentally on CT or MRI during an evaluation for an unrelated complaint. Although the majority of these are nonfunctional cortical adenomas, hormonally active tumors and adrenocortical carcinoma must also be considered in the differential diagnosis. Rarely, retroperitoneal tumors may mimic an adrenal mass. We report a case of a 49-year-old man with anemia and weight loss who was found to have a large retroperitoneal mass arising from the adrenal gland. Surgical treatment involved en bloc resection of the right kidney, adrenal gland, segments 7 and 8 of the liver, and a portion of the right hemidiaphragm. Final pathology revealed a low-grade myofibrosarcoma. We believe that this is the first case report of a myofibrosarcoma of the adrenal gland. Myofibrosarcomas are rare malignant tumors composed of myofibroblasts that arise from the deep soft tissues. These tumors have a predilection for the head and neck, trunk, or extremities. Myofibrosarcomas can be differentiated from other sarcomas by immunohistochemical staining and pathologic features. We will briefly discuss the workup of an adrenal mass and focus on the diagnosis of myofibrosarcoma.
肾上腺肿块有多种表现形式。最常见的情况是，肾上腺肿块在因其他无关病症进行CT或MRI检查时被偶然发现。尽管这些肿块大多数是无功能的皮质腺瘤，但在鉴别诊断中也必须考虑有激素活性的肿瘤和肾上腺皮质癌。罕见情况下，腹膜后肿瘤可能会酷似肾上腺肿块。我们报告一例49岁男性患者，有贫血和体重减轻症状，发现肾上腺有一个巨大的腹膜后肿块。手术治疗包括整块切除右肾、肾上腺、肝脏第7和8段以及部分右侧膈肌。最终病理显示为低级别肌纤维肉瘤。我们认为这是肾上腺肌纤维肉瘤的首例病例报告。肌纤维肉瘤是由肌成纤维细胞构成的罕见恶性肿瘤，起源于深部软组织。这些肿瘤好发于头颈部、躯干或四肢。肌纤维肉瘤可通过免疫组化染色和病理特征与其他肉瘤相鉴别。我们将简要讨论肾上腺肿块的检查，并着重于肌纤维肉瘤的诊断。
