Yoshida Hiromichi, Nakajima Kazuaki, Hayashi Haruyuki, Kimura Shinjiro, Irie Yasufumi
Division of Internal Medicine, San-ai Memorial Hospital, Chiba, Japan.
Division of Surgery, San-ai Memorial Hospital, Chiba, Japan.
Oxf Med Case Reports. 2020 Jul 24;2020(7):omaa044. doi: 10.1093/omcr/omaa044. eCollection 2020 Jul.
We report the case of a 48-year-old man who was unexpectedly found by abdominal ultrasonography to have large retroperitoneal masses accompanied by Graves' disease. Computed tomography and magnetic resonance imaging further demonstrated giant fat-rich soft masses arising within both renal sinuses. Histopathological examination of the mass was performed twice at 5-year intervals, with both examinations indicating fatty tissue cells with chronic fibrous panniculitis. Intravenous pulse therapy and successive oral glucocorticoid therapy were ineffective against Graves' ophthalmopathy or mass lesion. An antithyroid hormone regimen was followed by subtotal thyroid resection, leading to improvements in hyperthyroidism. Mass growth then attenuated slowly as the thyroid hormones returned to normal levels. The long-term follow-up of this patient should carefully monitor the appearance of warning signs such as mass effects.
我们报告了一例48岁男性患者，其经腹部超声意外发现有巨大腹膜后肿块，并伴有格雷夫斯病。计算机断层扫描和磁共振成像进一步显示双侧肾窦内出现富含脂肪的巨大软组织肿块。对该肿块进行了组织病理学检查，间隔5年进行了两次检查，两次检查均显示为伴有慢性纤维性脂膜炎的脂肪组织细胞。静脉脉冲治疗和连续口服糖皮质激素治疗对格雷夫斯眼病或肿块病变均无效。采用抗甲状腺激素方案后行甲状腺次全切除术，甲亢症状有所改善。随着甲状腺激素恢复正常水平，肿块生长随后缓慢减弱。对该患者的长期随访应仔细监测如肿块效应等警示信号的出现。
