Komai Yoshinobu, Kawakami Satoru, Yoshida Soichiro, Sakai Yasuyuki, Kobayashi Tsuyoshi, Kageyama Yukio, Kihara Kazunori
Department of Urology, Tokyo Medical and Dental University.
Hinyokika Kiyo. 2006 Jul;52(7):549-51.
A 35-year-old man presented with a 17-month history of abdominal distension and left upper quadrant pain. He had no episodes suggesting the presence of hypertension. Hormonal studies were insignificant. Imaging studies demonstrated a bulky tumor with cyst formation measuring 22 cm. Preoperative differential diagnoses included an adrenal tumor, extra-adrenal retroperitoneal tumor and pancreatic mucinous tumor. Intraoperatively, no abnormality was observed in the pancreas. A tight adhesion of the tumor to the left kidney necessitated an en bloc resection of the tumor with the left kidney. The resected specimen, 22 x 20 x 8 cm, weighed 5,050 g. Pathologically, the tumor was ganglioneuroma originating from the left adrenal gland. Convalescence was uneventful, and abdominal symptoms disappeared. The patient has been doing well without evidence of recurrece 48 months after the operation.
一名35岁男性,有17个月的腹胀和左上腹疼痛病史。他没有提示高血压存在的发作情况。激素检查无明显异常。影像学检查显示一个大小为22厘米、有囊肿形成的巨大肿瘤。术前鉴别诊断包括肾上腺肿瘤、肾上腺外腹膜后肿瘤和胰腺黏液性肿瘤。术中,胰腺未观察到异常。肿瘤与左肾紧密粘连,因此需要将肿瘤与左肾整块切除。切除标本大小为22×20×8厘米,重5050克。病理检查显示,该肿瘤为起源于左肾上腺的神经节神经瘤。康复过程顺利,腹部症状消失。术后48个月,患者情况良好,无复发迹象。