Tojal André, Santos Natália, Vicente João, Carrilho Noel, Casimiro Carlos
Department of General Surgery, Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
J Surg Case Rep. 2020 Nov 24;2020(11):rjaa451. doi: 10.1093/jscr/rjaa451. eCollection 2020 Nov.
Primary retroperitoneal teratomas involving adrenal glands are extremely uncommon, particularly in elderly males. Only a few case reports have been documented in the literature so far. We report a mature cystic retroperitoneal teratoma in the region of left adrenal gland in an asymptomatic 75-year-old male patient. It was incidentally found on an abdominal computed tomography scan and was thought to be an adrenal adenoma. Because of its relatively large size and the patient's request, he underwent a laparoscopic left adrenalectomy. Histopathological examination revealed a benign mature cystic retroperitoneal teratoma in the region of the left adrenal gland. The patient had an uneventful postoperative course and is free of recurrence after 20 months of follow-up. Considering the diagnostic difficulty of retroperitoneal teratoma by radiologic imaging, and its risk of malignancy, surgical resection via a minimally invasive approach would be the best diagnostic and therapeutic option. A literature review on teratomas is included.
原发性腹膜后畸胎瘤累及肾上腺极为罕见,尤其是在老年男性中。迄今为止,文献中仅有少数病例报告。我们报告一例75岁无症状男性患者,其左肾上腺区域有一个成熟的囊性腹膜后畸胎瘤。该肿瘤是在腹部计算机断层扫描时偶然发现的,最初被认为是肾上腺腺瘤。由于其相对较大的尺寸以及患者的要求,他接受了腹腔镜下左肾上腺切除术。组织病理学检查显示左肾上腺区域为良性成熟囊性腹膜后畸胎瘤。患者术后恢复顺利,随访20个月无复发。考虑到腹膜后畸胎瘤通过影像学诊断存在困难及其恶变风险,经微创方法进行手术切除将是最佳的诊断和治疗选择。本文还包括对畸胎瘤的文献综述。