Amendolara M, Barbarino C, Bucca D, Guarnieri F, Novello G B, Romano F M, Stevanato G, Ranzato R
Presidio Ospedaliero di Chioggia, ASL 14 - Regione Veneto, Unità Operativa di Chirurgia Generale.
G Chir. 2008 Mar;29(3):85-8.
The adrenal myelolipoma is a relatively rare benign tumour of adipose cell and bone marrow elements, non functioning and asymptomatic. Giant and bilateral adrenal myelolipoma is quite rare. The Authors report a case of bilateral adrenal myelolipoma, a giant one (> 15 cm) on the left side and a small one (> 4 cm) on the right with constant pain in a 57-year-old man, shown by computerized tomography. The hormonal blood tests were normal. Surgical excision was performed for large left symptomatic mass, by open laparotomy, and biopsy for right minor adrenal lesion. Histology confirmed diagnosis of myelolipoma for both masses. Follow-up to 6-12 months did'nt show any change of the right myelolipoma. The authors agree with the need to remove the giant adrenal myelolipoma, because the lesion > 10 cm have a high risk of cancer and hemorrhagic complication, while for small myelolipoma (< 6 cm) 6-12 months follow-up is the appropriate choice.
肾上腺髓脂肪瘤是一种相对罕见的由脂肪细胞和骨髓成分构成的良性肿瘤,无功能且无症状。巨大双侧肾上腺髓脂肪瘤相当罕见。作者报告了一例双侧肾上腺髓脂肪瘤病例,一名57岁男性,左侧为巨大型(>15 cm),右侧为小型(>4 cm),计算机断层扫描显示左侧持续疼痛。血液激素检查正常。对有症状的左侧大肿块行开放剖腹手术切除,对右侧较小的肾上腺病变进行活检。组织学检查证实两个肿块均为髓脂肪瘤。随访6至12个月,右侧髓脂肪瘤无任何变化。作者认同需要切除巨大肾上腺髓脂肪瘤,因为大于10 cm的病变有较高的癌变和出血并发症风险,而对于小型髓脂肪瘤(<6 cm),6至12个月的随访是合适的选择。