Singaporewalla Reyaz M, Thamboo Thomas P, Rauff Abu, Cheah Wei K, Mukherjee Jagat J
Department of Surgery, National University Hospital, Singapore.
Asian J Surg. 2009 Jul;32(3):172-6. doi: 10.1016/S1015-9584(09)60390-0.
Adrenal lipomas are rare, non-functioning benign tumours, which are primarily detected during autopsy or imaging, as asymptomatic incidentalomas. Occasionally, they can present with abdominal pain due to their large size. Imaging studies help to determine the origin, volume, composition of the lesion and presence of bleeding. Histopathology, however, is necessary to differentiate an adrenal lipoma from other fatty tumours such as myelolipoma, angiomyolipomas, teratomas and liposarcomas. We report a case of spontaneous bleeding from a giant adrenal lipoma that presented as an acute abdomen, and was initially mistaken on imaging for the more common myelolipoma. The literature is reviewed to discuss the clinical, pathological and radiological features, and the optimum therapeutic management.
肾上腺脂肪瘤是罕见的无功能良性肿瘤，主要在尸检或影像学检查时作为无症状偶发瘤被发现。偶尔，它们可能因体积大而出现腹痛。影像学检查有助于确定病变的起源、体积、成分以及是否存在出血。然而，组织病理学对于区分肾上腺脂肪瘤与其他脂肪性肿瘤，如髓脂肪瘤、血管平滑肌脂肪瘤、畸胎瘤和脂肪肉瘤是必要的。我们报告一例巨大肾上腺脂肪瘤自发性出血，表现为急腹症，最初在影像学上被误诊为更常见的髓脂肪瘤。本文回顾相关文献，讨论其临床、病理和放射学特征以及最佳治疗方法。
