Phitayakorn Roy, Maclennan Gregory, Sadow Peter, Wilhelm Scott
Department of Surgery, The Massachusetts General Hospital, Harvard Medical School, Boston, MA;
Rare Tumors. 2011 Apr 4;3(2):e21. doi: 10.4081/rt.2011.e21.
We present the clinical course of a patient with human immunodeficiency virus and an adrenal adenomatoid tumor (AAT). We describe the clinical course and laboratory, radiographic, and microscopic findings of a patient with human immunodeficiency virus (HIV) and an adenomatoid tumor of the right adrenal gland. A review of the literature was also done via electronic searches through PubMed for articles from 1965 to 2008 that contained the following search terms, adenomatoid tumor limited to the English language only. A 22 year-old African-American male with HIV was incidentally found to have a hypermetabolic right adrenal mass. The patient underwent laparoscopic adrenalectomy and the mass had morphological and immunohistochemical features that were consistent with an AAT. A review of the medical literature reveals that almost all cases of AAT were in male patients (96%) with a mean age of 41±11 years (range=22-64) with no significant difference in laterality (right side=46%, left side=50%, unknown=4%). AAT have an average size of 4.2±3.5 cm (range=0.5-14.3 cm). Pre-operative imaging studies do not appear to be able to reliably distinguish AAT from other types of adrenocortical tumors. For reasons that require further research, AAT typically occur in male patients and may be associated with immunosuppression. AAT can be safely removed laparoscopically with no evidence of long-term recurrence even with tumor extension beyond the adrenal capsule.
我们报告了一例患有人类免疫缺陷病毒（HIV）和肾上腺腺瘤样瘤（AAT）患者的临床病程。我们描述了一名患有HIV和右肾上腺腺瘤样瘤患者的临床病程以及实验室、影像学和显微镜检查结果。还通过电子检索PubMed对1965年至2008年的文献进行了回顾，搜索词为“腺瘤样瘤”，仅限于英文文章。一名22岁的非裔美国HIV男性患者偶然发现右肾上腺有一个代谢活跃的肿块。患者接受了腹腔镜肾上腺切除术，肿块的形态学和免疫组化特征与AAT一致。医学文献回顾显示，几乎所有AAT病例均为男性患者（96%），平均年龄为41±11岁（范围=22 - 64岁），左右侧无显著差异（右侧=46%，左侧=50%，未知=4%）。AAT平均大小为4.2±3.5 cm（范围=0.5 - 14.3 cm）。术前影像学检查似乎无法可靠地将AAT与其他类型的肾上腺皮质肿瘤区分开来。由于需要进一步研究的原因，AAT通常发生在男性患者中，可能与免疫抑制有关。即使肿瘤延伸至肾上腺包膜外，AAT也可通过腹腔镜安全切除，且无长期复发的证据。
