Ramareddy Raghu Sampally, Alladi Anand
Department of Pediatric Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
Indian J Med Paediatr Oncol. 2017 Jul-Sep;38(3):256-260. doi: 10.4103/ijmpo.ijmpo_33_16.
Adrenal mass may be functioning or nonfunctioning with varied clinical presentations. This study aimed to report the nature and management of uncommon adrenal mass and to review literature.
This was an retrospective observational analysis of children with uncommon adrenal mass admitted during 2009-2015. Clinical features, investigations, and management of patients were analyzed.
Among six, two each were adolescent and neonate, and one each was young infant and prenatal. Clinical presentation was variable; hypertensive retinopathy,[1] virilization[1] and bleeding diathesis,[1] antenatal suprarenal mass,[1] prenatal adrenal angiolipoma,[1] and spontaneous resolution of Stage III suprarenal mass.[1] Ultrasound and contrast-enhanced computed tomography revealed well-defined, heterogeneous adrenal mass. Size varied from 2 to 15 cm. Urinary metanephrine and serum testosterone were raised in adolescent hypertensive boys and virilized girls, respectively. Laparoscopy-assisted adrenalectomy was done in two and other four were managed conservatively. Histopathology of tumor revealed pheochromocytoma and borderline oncocytoma. Spontaneous resolution of adrenal mass had varied etiology; adrenal hemorrhagic lesion,[1] simple cyst,[1] neuroblastoma.[1] Follow-up varied from 3 months to 2 years. All patients were asymptomatic on last follow-up.
Close clinical follow-up, contrast-enhanced tomography, and limited/specific endocrine work-up have definite role in the management of uncommon adrenal mass.
肾上腺肿物可能有功能或无功能，临床表现各异。本研究旨在报告罕见肾上腺肿物的性质及处理方法，并复习相关文献。
这是一项对2009年至2015年期间收治的患有罕见肾上腺肿物儿童的回顾性观察分析。对患者的临床特征、检查及处理方法进行了分析。
6例患者中，青少年和新生儿各2例，幼儿和产前诊断各1例。临床表现多样，包括高血压性视网膜病变[1]、男性化[1]和出血倾向[1]、产前肾上腺肿物[1]、产前肾上腺血管脂肪瘤[1]以及Ⅲ期肾上腺肿物自发消退[1]。超声和增强CT显示肾上腺肿物边界清晰、密度不均。大小从2厘米至15厘米不等。青少年高血压男孩和男性化女孩的尿间甲肾上腺素和血清睾酮分别升高。2例行腹腔镜辅助肾上腺切除术，另外4例采取保守治疗。肿瘤组织病理学检查显示为嗜铬细胞瘤和临界性嗜酸性细胞瘤。肾上腺肿物自发消退病因各异，包括肾上腺出血性病变[1]、单纯囊肿[1]、神经母细胞瘤[1]。随访时间从3个月至2年不等。末次随访时所有患者均无症状。
密切的临床随访、增强CT检查以及有限的/特定的内分泌检查在罕见肾上腺肿物的处理中具有明确作用。
