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肾上腺皮质-髓质混合瘤——一种临床和病理上的变色龙:病例报告及文献复习。

Corticomedullary mixed tumor of the adrenal gland-a clinical and pathological chameleon: case report and review of literature.

机构信息

Department of General and Endocrine Surgery, CHR Huriez, Lille Cedex, France.

出版信息

Updates Surg. 2013 Jun;65(2):161-4. doi: 10.1007/s13304-011-0132-1. Epub 2012 Jan 7.

Abstract

Adrenal tumors mostly present with specific and unique clinical features, regarding their endocrine metabolism. A 53-year-old man came to our Department for a left adrenal mass discovered incidentally. Biochemical and imaging findings were suspicious for a pheochromocytoma. The patient underwent a laparoscopic left adrenalectomy. A well-circumscribed 5.5-cm mass was removed. It was composed of adrenal cells intimately admixed with pheochromocytes. Immunohistochemical studies were positive both for cortical cells (inibin-α, synaptophysine and melan-A) and medullary cells (S-100 and chromogranine A). Final pathology was of corticomedullary mixed tumor (CMT). CMT is a rare tumor with 14 cases previously reported in literature, with wide variable biochemical behavior, such as his radiological and pathological features. Prevalence and actual malignant potential are yet unknown to our knowledge.

摘要

肾上腺肿瘤主要表现为其内分泌代谢方面的特异性和独特的临床特征。一名 53 岁男性因偶然发现左侧肾上腺肿块来到我科就诊。生化和影像学检查结果提示嗜铬细胞瘤的可能性较大。患者接受了腹腔镜左肾上腺切除术。切除了一个边界清楚的 5.5 厘米肿块。该肿块由肾上腺细胞与嗜铬细胞密切混合而成。免疫组织化学研究显示皮质细胞(inhibin-α、突触素和黑素-A)和髓质细胞(S-100 和嗜铬粒蛋白 A)均为阳性。最终的病理诊断为皮质-髓质混合瘤(CMT)。CMT 是一种罕见的肿瘤,文献中已有 14 例报道,其生化行为具有广泛的可变性,如本例的影像学和病理学特征。据我们所知,其患病率和实际恶性潜能尚不清楚。

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