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一例儿童 Beckwith-Wiedemann 综合征患者异位肾上腺皮质中同步功能性肾上腺皮质腺瘤和骨髓脂肪瘤的独特病例。

A unique case of synchronous functional adrenocortical adenoma and myelolipoma within the ectopic adrenal cortex in a child with Beckwith-Wiedemann syndrome.

机构信息

Department of Pathology, Boldrini Children's Hospital, Campinas, SP, Brazil.

出版信息

Pathol Res Pract. 2012 Mar 15;208(3):189-94. doi: 10.1016/j.prp.2011.12.011. Epub 2012 Feb 5.

DOI:10.1016/j.prp.2011.12.011
PMID:22309953
Abstract

We report a unique case of synchronous functional adrenocortical adenoma and an incidental myelolipoma within ectopic cortical adrenal tissue located in the renal hilum in a child with Beckwith-Wiedemann syndrome and review the association between adrenal gland disorders and myelolipomas. To the best of our knowledge, this is the first documented case of a simultaneous occurrence of these three conditions. A 17-month-old child with Beckwith-Wiedemann syndrome was diagnosed with a left adrenal tumor during complementary radiologic studies. Biochemical investigation before surgery showed elevated blood levels of cortisol and dehydroepiandrosterone hormones. The patient underwent a left adrenalectomy with ipsilateral renal hilar and intercaval-aortic lymph node dissection. Pathology findings revealed a left adrenocortical adenoma and an incidental myelolipoma growing within ectopic cortical adrenal tissue in the renal hilum. The patient is doing well and does not have any current health issues. Patients with adrenal cortex disorders, such as hyperplasias and neoplasms, particularly when associated with hormonal imbalances, may have an increased risk of developing myelolipomas. Whether Beckwith-Wiedemann syndrome may, by itself, contribute to simultaneous occurrence of adrenocortical adenomas and myelolipomas remains to be clarified.

摘要

我们报告了一例独特的病例,一名患有 Beckwith-Wiedemann 综合征的儿童的肾门处异位皮质肾上腺组织中同时存在功能性肾上腺皮质腺瘤和偶发的骨髓脂肪瘤,并且回顾了肾上腺疾病与骨髓脂肪瘤之间的关联。据我们所知,这是这三种情况同时发生的首例记录病例。一名 17 个月大的 Beckwith-Wiedemann 综合征患儿在补充影像学研究中被诊断出左肾上腺肿瘤。手术前的生化研究显示皮质醇和脱氢表雄酮激素的血液水平升高。患儿接受了左侧肾上腺切除术,并进行同侧肾门和腔静脉-主动脉淋巴结清扫术。病理检查结果显示左肾上腺皮质腺瘤和偶发的骨髓脂肪瘤生长在肾门处异位皮质肾上腺组织中。患儿情况良好,目前无健康问题。患有肾上腺皮质增生和肿瘤等疾病的患者,特别是当伴有激素失衡时,发生骨髓脂肪瘤的风险可能会增加。Beckwith-Wiedemann 综合征本身是否会导致肾上腺皮质腺瘤和骨髓脂肪瘤同时发生,仍有待阐明。

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