原发性肾上腺平滑肌肉瘤伴淋巴结转移：一例报告
Primary adrenal leiomyosarcoma with lymph node metastasis: a case report.
作者信息
Onishi Tomoya, Yanagihara Yutaka, Kikugawa Tadahiko, Miura Noriyoshi, Noda Terutaka, Kakuda Toshio, Kitazawa Riko, Tanji Nozomu
机构信息
Department of Urology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan.
Division of Diagnostic Pathology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan.
出版信息
World J Surg Oncol. 2016 Jul 2;14(1):176. doi: 10.1186/s12957-016-0936-z.
BACKGROUND
Leiomyosarcomas typically originate in smooth muscle cell. Leiomyosarcoma potentially arising from the adrenal gland is an extremely rare mesenchymal tumors associated with delayed diagnosis and poor prognosis.
CASE PRESENTATION
A 34-year-old man visited our department complaining of right hypochondriac pain. Computed tomography demonstrated a solid mass measuring 5.2 cm in diameter above the right kidney, corresponding to the right adrenal gland, and a lymph node mass, which appeared to have invaded the IVC wall. Right adrenalectomy and lymphadenectomy were performed. A microscopic examination revealed primary adrenal leiomyosarcoma with lymph node metastasis. No adjuvant therapy was performed, and the patient remains recurrence-free at 10 months postoperatively.
CONCLUSIONS
We experienced a very rare case of primary adrenal leiomyosarcoma. Aggressive surgical resection including vascular reconstruction may be associated with improved survival.
背景
平滑肌肉瘤通常起源于平滑肌细胞。肾上腺潜在发生的平滑肌肉瘤是一种极其罕见的间叶性肿瘤，其诊断往往延迟且预后较差。
病例报告
一名34岁男性因右侧季肋部疼痛前来我院就诊。计算机断层扫描显示右肾上方有一个直径5.2厘米的实性肿块，对应于右侧肾上腺，还有一个淋巴结肿块，似乎已侵犯下腔静脉壁。遂行右侧肾上腺切除术及淋巴结清扫术。显微镜检查显示为原发性肾上腺平滑肌肉瘤伴淋巴结转移。未进行辅助治疗，患者术后10个月无复发。
结论
我们遇到了一例非常罕见的原发性肾上腺平滑肌肉瘤病例。积极的手术切除，包括血管重建，可能会提高生存率。
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