Maru Shintaro, Yamashita Noboru, Shinno Yuichiro
Department of Urology, Otaru Municipal Hospital.
Nihon Hinyokika Gakkai Zasshi. 2007 May;98(4):643-5. doi: 10.5980/jpnjurol1989.98.643.
A 79-year-old man was consulted to our hospital for further examination of right adrenal tumor shown by computed tomography. Complete blood cell count, biochemical tests, hormonal examinations and urinalysis were normal. 131I-adosterol scintigram showed decreased uptake on the right adrenal. Right adrenalectomy was done in consider to adrenal cancer. By the pathological findings and the serological tests (ELISA, and Western Blot examination), the tumor was diagnosed as an adrenal multilocular echinococcosis. Mainly, Echinococcosis caused by echinococcus granulosus and echinococcus multilocularis. While E. granulosus is endemic in Europe and Mediterranean coast etc., E. multilocularis is endemic in Japan and North America etc. In E. multilocularis, about 98% of the primary cyst are localized in the liver and the cyst are localized in the lung and brain etc, are rare. In Europe, the primary hydatid cyst is found in the adrenal in only 0.05% of the total case. Moreover, adrenal multilocular echinococcosis is extremely rare case, and is not presented yet in the world. By the patient' s residential history, echinococcosis shoud be considered to differential diagnosis of the adrenal tumor in urology.
一名79岁男性因计算机断层扫描显示右肾上腺肿瘤前来我院进一步检查。全血细胞计数、生化检查、激素检查及尿液分析均正常。131I - 阿多甾醇闪烁扫描显示右肾上腺摄取减少。考虑到肾上腺癌，进行了右肾上腺切除术。通过病理检查结果和血清学检测（酶联免疫吸附测定和蛋白质印迹检测），该肿瘤被诊断为肾上腺多房性包虫病。包虫病主要由细粒棘球绦虫和多房棘球绦虫引起。细粒棘球绦虫在欧洲和地中海沿岸等地为地方性流行，而多房棘球绦虫在日本和北美等地为地方性流行。在多房棘球绦虫病中，约98%的原发囊肿位于肝脏，位于肺和脑等部位的囊肿较为罕见。在欧洲，仅0.05%的包虫病患者原发囊肿位于肾上腺。此外，肾上腺多房性包虫病极为罕见，在世界范围内尚未见报道。根据患者的居住史，在泌尿外科中，包虫病应被考虑作为肾上腺肿瘤鉴别诊断的因素。
