Division of Endocrine Surgery, Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Endocr Pract. 2012 May-Jun;18(3):335-41. doi: 10.4158/EP11240.OR.
To report 10 cases of neoplasms that were initially thought to be primarily adrenal-derived masses but were later confirmed as tumors of a different origin.
Between 2000 and 2011, a total of 229 patients underwent adrenalectomy at our institution. Of this overall group, 10 patients had retroperitoneal pathologic conditions mimicking adrenal tumors. Using an institutional review board-approved database, we reviewed the clinical, biochemical, and radiologic characteristics of these 10 patients.
The study cohort consisted of 4 male and 6 female patients. The mean age of these 10 patients was 48 years. The pathologic conditions included schwannoma (n = 3), leiomyosarcoma (n = 2), and 1 each of metastatic angiosarcoma, metastatic granulosa cell tumor, retroperitoneal hematoma, perivascular epithelioid cell tumor, and bronchogenic cyst. The patient with angiosarcoma had elevated plasma and urine catecholamines and a positive metaiodobenzylguanidine scan, whereas the others had normal findings on biochemical work-up. A percutaneous biopsy was performed preoperatively in 2 patients. All patients, except the patient with hematoma, underwent abdominal exploration, which was laparoscopic in 5, open in 2, and robotic in 2. With exclusion of the patients with angiosarcoma and hematoma, resection was possible in all the remaining patients.
In this report we describe our experience with retroperitoneal masses mimicking adrenal tumors. Increased awareness of these unusual pathologic conditions is important for appropriate clinical management of these tumors. The presentation of the patients and the surgical management of these individual pathologic entities are highlighted.
报告 10 例最初被认为是主要源自肾上腺的肿块，但后来被确认为起源不同的肿瘤。
在 2000 年至 2011 年期间，我们医院共对 229 例患者进行了肾上腺切除术。在这一总体组中，有 10 例患者的腹膜后病理状况类似于肾上腺肿瘤。我们使用机构审查委员会批准的数据库，回顾了这 10 例患者的临床、生化和影像学特征。
研究队列包括 4 名男性和 6 名女性患者。这 10 名患者的平均年龄为 48 岁。病理状况包括神经鞘瘤（n = 3）、平滑肌肉瘤（n = 2）、转移性血管肉瘤、转移性颗粒细胞瘤、腹膜后血肿、血管周上皮样细胞瘤和支气管源性囊肿各 1 例。血管肉瘤患者的血浆和尿液儿茶酚胺升高，间碘苄胍扫描阳性，而其他患者的生化检查正常。2 例患者术前进行了经皮活检。除血肿患者外，所有患者均接受了腹部探查，其中 5 例为腹腔镜，2 例为开放手术，2 例为机器人手术。排除血管肉瘤和血肿患者后，其余患者均可进行切除。
在本报告中，我们描述了我们对腹膜后肿块模拟肾上腺肿瘤的经验。提高对这些不常见病理状况的认识对于这些肿瘤的适当临床管理很重要。强调了患者的表现和这些个体病理实体的手术处理。
