Soydan Levent, Demir Ali Aslan, Sayman Elif, Onomay Celik Burcu, Oven Ustaalioglu Bala Basak
Department of Radiology, Haydarpasa Numune Research and Educational Hospital, Tıbbiye Street No: 23 34668 Uskudar, Istanbul, Turkey.
Department of Radiology, Istanbul University Capa Faculty of Medicine, Istanbul, Turkey.
Radiol Case Rep. 2017 Jul 31;12(4):838-844. doi: 10.1016/j.radcr.2017.07.002. eCollection 2017 Dec.
Ewing sarcoma and peripheral primitive neuroectodermal tumor belong to the Ewing sarcoma (ES) family of tumors originating from a primitive neural tube. We report a 31-year-old man who was admitted to the urology clinic with complaints of fever, nausea, and dysuria. A right-sided adrenal mass was detected during ultrasonography. The lesion was then evaluated with magnetic resonance imaging, which showed areas of necrosis amid heterogeneous solid areas. Whole body scan with 2-deoxy-2-[fluorine-18]fluoro-D-glucose integrated with computed tomography and bone scan studies showed pulmonary and osseous metastatic foci. The mass and right kidney were removed by an open approach. An immunohistochemical and molecular workup enabled the diagnosis of ES. The patient also underwent radiotherapy and chemotherapy. The patient remained in fairly good health during the 18-month follow-up period, but showed progression of all metastatic foci and died 26 months after treatment. In conclusion, adrenal ES should be included in the differential diagnosis of nonfunctional adrenal lesions despite its rare occurrence.
尤因肉瘤和外周原始神经外胚层肿瘤属于起源于原始神经管的尤因肉瘤（ES）肿瘤家族。我们报告一名31岁男性，因发热、恶心和排尿困难主诉入住泌尿外科门诊。超声检查发现右侧肾上腺肿块。随后用磁共振成像对病变进行评估，结果显示在不均匀实性区域中有坏死区域。结合计算机断层扫描和骨扫描研究的2-脱氧-2-[氟-18]氟-D-葡萄糖全身扫描显示有肺和骨转移灶。通过开放手术切除肿块和右肾。免疫组织化学和分子检查确诊为ES。患者还接受了放疗和化疗。在18个月的随访期内，患者健康状况尚可，但所有转移灶均有进展，治疗26个月后死亡。总之，尽管肾上腺ES罕见，但在无功能肾上腺病变的鉴别诊断中应考虑到。
