Târcoveanu Eugen, Dimofte Gabriel, Bradea Costel, Moldovanu Radu, Vasilescu Alin, Anton Raluca, Ferariu Dan
First Surgical Clinic, "St. Spiridon" Hospital, University of Medicine, Iaçsi, Romania.
JSLS. 2009 Jan-Mar;13(1):116-9.
Adrenal schwannomas are very rare tumors that are difficult to diagnose preoperatively. We report the case of a left adrenal schwannoma incidentally discovered in a 55-year-old man during a postoperative checkup for a cutaneous malignant melanoma.
The biological evaluation was unremarkable, and the radiological examination revealed the adrenal mass that was first considered a metastatic lesion. Adrenalectomy was performed by the laparoscopic approach.
The postoperative course was uneventful. Histological examination established the correct diagnosis of schwannoma, which was also confirmed by immunohistochemical staining.
A nonsecreting adrenal mass can be easily misjudged, especially in the context of a recently operated on malignancy. Unilateral adrenal metastasis needs pathological confirmation, as it can dramatically affect prognosis. Unusual tumors of the adrenal gland may be found incidentally, and a malignant context will generate difficulties in establishing the right management. Complete laparoscopic excision is the treatment of choice whenever feasible and will also clarify pathology.
肾上腺神经鞘瘤是非常罕见的肿瘤，术前很难诊断。我们报告一例55岁男性，在皮肤恶性黑色素瘤术后检查时偶然发现左侧肾上腺神经鞘瘤。
生物学评估无异常，放射学检查发现肾上腺肿块，最初被认为是转移灶。通过腹腔镜手术行肾上腺切除术。
术后过程顺利。组织学检查确诊为神经鞘瘤，免疫组化染色也证实了这一诊断。
无分泌功能的肾上腺肿块很容易被误诊，尤其是在近期有恶性肿瘤手术史的情况下。单侧肾上腺转移需要病理证实，因为它会显著影响预后。肾上腺的罕见肿瘤可能会偶然发现，而恶性肿瘤的情况会给确定正确的治疗方案带来困难。只要可行，完全腹腔镜切除是首选的治疗方法，并且也能明确病理。
