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原发性肾上腺畸胎瘤:一种罕见肿瘤——诊断与手术治疗中的挑战

Primary adrenal teratoma: An unusual tumor - Challenges in diagnosis and surgical management.

作者信息

Ramakant P, Rana C, Singh K R, Mishra A

机构信息

Department of Endocrine Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.

Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India.

出版信息

J Postgrad Med. 2018 Apr-Jun;64(2):112-114. doi: 10.4103/jpgm.JPGM_588_16.

Abstract

We report a rare case of a 25-year-old lady who presented with right hypochondriac pain associated with weakness for 3 months. Her hormonal evaluation was normal. Computed tomography scan revealed an adrenal mass for which a right open transperitoneal adrenalectomy was performed, and the lesion was diagnosed as mature teratoma on histopathological examination. Teratoma is an unusual neoplasm which arises from one or all the three germ layers. Extragonadal teratomas are rare in adults as compared to children and are mostly retroperitoneal in location, constituting only 4% of all primary teratomas. Primary adrenal teratomas are even rarer and to the best of our knowledge, only eight cases have been reported in adults in the past 10 years. Adrenal teratoma can pose a diagnostic challenge because radiologically it mimics myelolipoma, angiomyolipoma, liposarcoma, or pheochromocytoma. Mature teratomas are usually benign but may possess malignant potential, the chances of which are greater in adults as compared to children, making it an important entity requiring a proper diagnosis and management.

摘要

我们报告了一例罕见病例,一名25岁女性,出现右侧季肋部疼痛并伴有乏力3个月。她的激素评估结果正常。计算机断层扫描显示肾上腺有一个肿块,遂行右侧开放式经腹肾上腺切除术,组织病理学检查将该病变诊断为成熟畸胎瘤。畸胎瘤是一种不常见的肿瘤,起源于三个胚层中的一个或全部。与儿童相比,性腺外畸胎瘤在成人中较为罕见,且大多位于腹膜后,仅占所有原发性畸胎瘤的4%。原发性肾上腺畸胎瘤更为罕见,据我们所知,过去10年中成人病例仅报道过8例。肾上腺畸胎瘤在诊断上可能具有挑战性,因为在放射学上它可模仿肾上腺髓质脂肪瘤、血管平滑肌脂肪瘤、脂肪肉瘤或嗜铬细胞瘤。成熟畸胎瘤通常为良性,但可能具有恶性潜能,与儿童相比,成人中出现这种情况的几率更大,这使得它成为一个需要正确诊断和处理的重要病症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfe2/5954807/7450e7bdd0db/JPGM-64-112-g001.jpg

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