Geleit Ryan James, Bhardwaj Rakesh, Fish David, Sriprasad Seshadri
Darent Valley Hospital, Dartford, UK.
Department of General Surgery, Dartford and Gravesham NHS Trust, Dartford, UK.
BMJ Case Rep. 2016 Oct 28;2016:bcr2016216246. doi: 10.1136/bcr-2016-216246.
A man aged 33 years presented with a 3-day history of left-sided testicular discomfort. Clinical examination revealed a large left-sided varicocele. He was referred for a testicular ultrasound, which demonstrated a moderate left-sided varicocele and an associated large suprarenal mass. An urgent (CT) scan was arranged which confirmed this, with associated compression of adjacent structures, including the left kidney and left renal vessels. The patient was admitted 1 week following the CT scan with features of sepsis. An inpatient adrenal MRI scan suggested the presence of a large left-sided haemorrhagic adrenal cyst. This was removed surgically through a left subcostal incision. Histology confirmed there was no malignancy. The patient was discharged and a follow-up CT scan at 6 months showed complete resolution of the cyst with no further testicular discomfort. This is the first known case of an adrenal cyst presenting with a varicocele.
一名33岁男性因左侧睾丸不适3天前来就诊。临床检查发现左侧有一个大的精索静脉曲张。他被转诊进行睾丸超声检查,结果显示左侧有中度精索静脉曲张,并伴有一个大的肾上腺肿块。随后安排了紧急计算机断层扫描(CT),证实了这一情况,且相邻结构包括左肾和左肾血管受到了相关压迫。CT扫描1周后,患者因脓毒症特征入院。住院期间的肾上腺磁共振成像(MRI)扫描提示左侧有一个大的出血性肾上腺囊肿。通过左肋下切口进行了手术切除。组织学检查证实无恶性病变。患者出院,6个月后的随访CT扫描显示囊肿完全消退,睾丸不再有不适。这是已知首例肾上腺囊肿伴精索静脉曲张的病例。