Yamada A H, Sherrod A E, Boswell W, Skinner D G
Department of Urology, University of Southern California, Los Angeles.
Urology. 1992 Jul;40(1):59-62. doi: 10.1016/0090-4295(92)90438-3.
We report an unusual case of spontaneous massive retroperitoneal hemorrhage from an adrenal gland metastasis. After medical therapy failed to stabilize the patient's condition, surgical exploration revealed a large retroperitoneal hematoma arising from a right adrenal gland metastasis. At the time of thoracoabdominal exploration in the lower lobe of right lung a small tumor nodule was palpated and resected. Pathologic examination of both lung and abdominal lesions revealed squamous cell carcinoma thought to have been primary in the lung. A review of the literature reveals that metastatic lesions to the adrenal gland are infrequently encountered clinically and rarely hemorrhage; the first such case in which massive retroperitoneal hemorrhage was a complication is reported in the urologic literature.
我们报告了一例罕见的肾上腺转移瘤自发性大量腹膜后出血病例。在药物治疗未能稳定患者病情后，手术探查发现一个由右肾上腺转移瘤引起的巨大腹膜后血肿。在对右肺下叶进行胸腹联合探查时，触诊到一个小肿瘤结节并将其切除。对肺部和腹部病变的病理检查显示为鳞状细胞癌，推测原发于肺部。文献回顾显示，肾上腺转移瘤在临床上很少见，且很少发生出血；泌尿外科文献中首次报道了以大量腹膜后出血为并发症的此类病例。
