Poiana Catalina, Carsote Mara, Chirita Corina, Terzea Dana, Paun S, Beuran M
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
J Med Life. 2010 Jul-Sep;3(3):308-13.
One of the rarest situations regarding an adrenal incidentaloma is an adrenal cyst. We present the case of a 61-year-old male patient diagnosed with peritonitis. During surgery, a right adrenal tumor of 2 cm is discovered. The patient was referred to endocrinology. 6 months later the diameter of the tumor is 7 times bigger than the initial stage. It has no secretory phenotype, except for the small increase of serum aldosterone and the 24-h 17-ketosteroids. Open right adrenalectomy is performed and a cyst of 15 cm is removed. The evolution after surgery is good. The pathological exam reveals an adrenal cyst with calcifications and osteoid metaplasia. The immunohistochemistry showed a positive reaction for CD34 and ACT in the vessels and VIM in the stroma. The adrenal cysts are not frequent and represent a challenge regarding the preoperative diagnostic and surgical procedure of resection. The pathological exam highlights the major aspects.
肾上腺偶发瘤中最罕见的情况之一是肾上腺囊肿。我们报告一例61岁男性患者，诊断为腹膜炎。手术过程中，发现一个2厘米的右肾上腺肿瘤。该患者被转诊至内分泌科。6个月后，肿瘤直径比初始阶段增大了7倍。除血清醛固酮和24小时17-酮类固醇略有升高外，它没有分泌表型。实施了开放性右肾上腺切除术，切除了一个15厘米的囊肿。术后恢复良好。病理检查显示为一个伴有钙化和骨样化生的肾上腺囊肿。免疫组化显示血管中CD34和ACT呈阳性反应，间质中VIM呈阳性反应。肾上腺囊肿并不常见，在术前诊断和手术切除程序方面是一个挑战。病理检查突出了主要方面。
