Tanaka T, Matsuo N, Ishikura H, Takagi D, Takeyama N
Emergency Care Unit Kansai Medical University, Osaka, Japan.
Jpn J Surg. 1989 Sep;19(5):597-606. doi: 10.1007/BF02471670.
A case of a 73 year old man who was preoperatively diagnosed as possibly having myelolipoma is presented herein. Adrenal myelolipoma is an uncommon benign tumor of which only 74 foreign cases and 43 Japanese cases have been previously reported in the literature dealing with surgically removed myelolipomas. The most consistent complaint of the adrenal myelolipoma sufferer is abdominal pain, caused by hemorrhaging in the tumor, and many cases are associated with obesity, hypertension and/or diabetes mellitus. There is now an increasing number of such cases being diagnosed during abdominal scanning with ultrasonography or computerized tomography for unrelated problems, whereupon the myelolipoma is usually surgically resected. With the availability of modern scanning techniques and fine needle biopsy, however, it should be possible to adopt a more conservative approach to the management of asymptomatic adrenal myelolipoma. Nevertheless, symptomatic or large tumors, must be removed since there is a high risk of spontaneous hemorrhage.
本文介绍了一例73岁男性患者，术前诊断可能患有肾上腺髓质脂肪瘤。肾上腺髓质脂肪瘤是一种罕见的良性肿瘤，在已报道的经手术切除的肾上腺髓质脂肪瘤的文献中，国外仅有74例，日本仅有43例。肾上腺髓质脂肪瘤患者最常见的症状是由肿瘤内出血引起的腹痛，许多病例还伴有肥胖、高血压和/或糖尿病。现在，越来越多的此类病例在因无关问题进行腹部超声或计算机断层扫描时被诊断出来，随后通常会对肾上腺髓质脂肪瘤进行手术切除。然而，随着现代扫描技术和细针活检的应用，对于无症状的肾上腺髓质脂肪瘤，应该有可能采取更保守的治疗方法。尽管如此，有症状的或较大的肿瘤必须切除，因为存在自发性出血的高风险。
