Koh Yoko, Asakura Toshihisa, Katayama Kinzo, Tei Norihide, Harada Yasunori, Nishimura Kensaku
The Department of Urology, Osaka National Hospital.
Hinyokika Kiyo. 2018 Nov;64(11):435-438. doi: 10.14989/ActaUrolJap_64_11_435.
A 69-year-old woman was admitted to the previous hospital because of a right adrenal tumor detected by a medical checkup. Although the tumor was diagnosed as non-functional adrenal adenoma, abdominal computed tomography (CT) revealed a left renal mass which was suspected to be renal cell carcinoma. Chest CT seeking for metastatic lesions revealed lung cancer of the left lung. First, laparoscopic radical nephrectomy was performed. After the surgery, 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) CT performed for staging of the lung cancer demonstrated FDG uptake to the left lung mass, the heart, the right adrenal mass and perirenal regions of the right kidney. The patient showed elevated serum catecholamine level and hypertensive emergency. She was admitted to our hospital with a suspicion of pheochromocytoma of the right adrenal gland and multiple paraganglioma. CT and magnetic resonance imaging showed that the heart and the perirenal regions had no tumors. We considered these lesions brown adipose tissue. Under the diagnosis of pheochromocytoma of the right adrenal gland, laparoscopic partial adrenalectomy was performed. The clinical course after the surgery was uneventful. FDG PET-CT revealed that FDG uptake to brown adipose tissue disappeared 6 months after the partial adrenalectomy.
一名69岁女性因体检发现右肾上腺肿瘤而入住前一家医院。尽管该肿瘤被诊断为无功能肾上腺腺瘤，但腹部计算机断层扫描（CT）显示左肾有一肿块，怀疑为肾细胞癌。胸部CT检查转移性病变时发现左肺有肺癌。首先，进行了腹腔镜根治性肾切除术。术后，为评估肺癌分期进行的18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）CT显示，左肺肿块、心脏、右肾上腺肿块及右肾肾周区域有FDG摄取。患者血清儿茶酚胺水平升高并出现高血压急症。她因怀疑右肾上腺嗜铬细胞瘤和多发副神经节瘤入住我院。CT和磁共振成像显示心脏和肾周区域无肿瘤。我们认为这些病变为棕色脂肪组织。在诊断为右肾上腺嗜铬细胞瘤后，进行了腹腔镜肾上腺部分切除术。术后临床过程平稳。FDG PET-CT显示，肾上腺部分切除术后6个月，棕色脂肪组织的FDG摄取消失。
