Sakata Ryoko, Tsuchiya Futoshi, Osaka Kimito, Fujikawa Atsushi, Ouchi Hidenori, Iwasaki Akira
The Depertment of Urology, Yokohama City Minato Red Cross Hospital, Japan.
Hinyokika Kiyo. 2012 Mar;58(3):149-53.
Spontaneous massive retroperitoneal hemorrhage from an adrenal tumor is rare and is usually fatal if unrecognized. We report a case of spontaneous rupture of a primary adrenocortical carcinoma that occurred in a 79-year-old man. He visited our hospital with left abdominal pain. Computed tomography (CT) showed a left retroperitoneal hemorrhage. We could not find the origin of this hemorrhage. Two months later, CT showed the left adrenal tumor, and left adrenalectomy and nephrectomy were performed successfully. The histological diagnosis was adrenocortical carcinoma. He rejected adjuvant therapy. Local recurrence of the tumor was found, and right adrenal gland, brain, and mediastinal lymph node metastases were recognized 6 months after the operation. He died 11 months after the operation.
肾上腺肿瘤引起的自发性大量腹膜后出血较为罕见，若未被识别通常会致命。我们报告一例发生在一名79岁男性身上的原发性肾上腺皮质癌自发性破裂病例。他因左侧腹痛前来我院就诊。计算机断层扫描（CT）显示左侧腹膜后出血。我们未能找到此次出血的源头。两个月后，CT显示左侧肾上腺肿瘤，遂成功实施了左侧肾上腺切除术和肾切除术。组织学诊断为肾上腺皮质癌。他拒绝辅助治疗。术后6个月发现肿瘤局部复发，并出现右侧肾上腺、脑及纵隔淋巴结转移。他于术后11个月死亡。
