Maciel C A, Tang Y Z, Coniglio G, Sahdev A
Department of Radiology, St Bartholomew's Hospital, Barts Health, West Smithfield, London EC1A 7BE, UK.
Department of Radiology, St Bartholomew's Hospital, Barts Health, West Smithfield, London EC1A 7BE, UK.
Clin Radiol. 2016 May;71(5):484-94. doi: 10.1016/j.crad.2016.01.025. Epub 2016 Mar 2.
Although adrenal medullary tumours are rare, they have important clinical implications. They form a heterogeneous group of tumours, ranging from benign, non-secretory, incidental masses to hormonally active tumours presenting acutely, or malignant tumours with disseminated disease and a poor prognosis. Increasingly, benign masses are incidentally detected due to the widespread use of imaging and routine medical check-ups. This review aims to illustrate the multimodality imaging appearances of rare adrenal medullary tumours, excluding the more common phaeochromocytomas, with clues to the diagnosis and to summarise relevant epidemiological and clinical data. Careful correlation of clinical presentation, hormone profile, and various imaging techniques narrow the differential diagnosis. Image-guided percutaneous adrenal biopsy can provide a definitive diagnosis, allowing for conservative management in selected cases. A close collaboration between the radiologist, endocrinologist, and surgeon is of the utmost importance in the management of these tumours.
尽管肾上腺髓质肿瘤较为罕见，但它们具有重要的临床意义。它们构成了一组异质性肿瘤，范围从良性、无分泌功能的偶然发现的肿块，到急性起病的激素活性肿瘤，或伴有播散性疾病且预后不良的恶性肿瘤。由于影像学检查和常规体检的广泛应用，越来越多的良性肿块被偶然发现。本综述旨在阐述罕见肾上腺髓质肿瘤（不包括较常见的嗜铬细胞瘤）的多模态影像学表现，并提供诊断线索，同时总结相关的流行病学和临床数据。仔细将临床表现、激素谱和各种影像学技术相互关联，可缩小鉴别诊断范围。影像引导下经皮肾上腺活检可提供明确诊断，从而在某些病例中实现保守治疗。放射科医生、内分泌科医生和外科医生之间的密切合作对于这些肿瘤的管理至关重要。
