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肾上腺畸胎瘤:临床经验与文献综述

Teratoma of the adrenal gland: clinical experience and literature review.

作者信息

He Cheng, Yang Yanli, Yang Yang, Wang Fuqin, Hu Jie, Zhang Jingjing, Yin Yu, Zeng Lili, Zhang Tijiang, Liu Heng

机构信息

Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China.

Medical Imaging Department, Chongqing University Central Hospital, Chongqing, China.

出版信息

Gland Surg. 2020 Aug;9(4):1056-1064. doi: 10.21037/gs-20-648.

Abstract

Teratoma originates from pluripotent cells of two or more than two germ cell layers, and most of them are benign. Teratomas are found in the ovaries and testes. Retroperitoneal teratoma is rare, especially adrenal teratoma. Here, we describe a rare case of a 17-year-old woman who was diagnosed with pulmonary tuberculosis and a right adrenal mass at the age of eight. So, she received anti-tuberculosis treatment. Nine years later, chest X-rays showed prior lesions in both lungs, and abdominal CT showed the mass in the right adrenal gland was larger than before, during this period she had no clinical symptoms. She underwent retroperitoneal laparoscopic adrenalectomy, and the pathological diagnosis was a mature teratoma of the right adrenal gland. During a one-year follow-up, the patients recovered well without any discomfort. Thirty-two cases were found in the literature review, among which no patients had a history of pulmonary tuberculosis. Adrenal teratoma is often seen in females and the left adrenal gland. The imaging features of adrenal teratoma can be cystic, solid, and cystic solids. Mature fat and calcification can be seen in most teratomas. Comprehensive analysis of clinical features and imaging characteristics can enhance the diagnostic confidence of radiologists in adrenal teratoma.

摘要

畸胎瘤起源于两个或两个以上胚层的多能细胞,大多为良性。畸胎瘤可见于卵巢和睾丸。腹膜后畸胎瘤罕见,肾上腺畸胎瘤尤为少见。在此,我们描述一例罕见病例,一名17岁女性8岁时被诊断为肺结核及右侧肾上腺肿块,因此接受了抗结核治疗。9年后,胸部X线显示双肺有陈旧性病灶,腹部CT显示右侧肾上腺肿块较前增大,在此期间她无临床症状。她接受了腹膜后腹腔镜肾上腺切除术,病理诊断为右侧肾上腺成熟畸胎瘤。在为期一年的随访中,患者恢复良好,无任何不适。文献复习发现32例,其中无患者有肺结核病史。肾上腺畸胎瘤多见于女性及左侧肾上腺。肾上腺畸胎瘤的影像学特征可为囊性、实性及囊实性。大多数畸胎瘤可见成熟脂肪和钙化。综合分析临床特征和影像学特点可提高放射科医生对肾上腺畸胎瘤的诊断信心。

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