Zhou Cathy, Fananapazir Ghaneh, Campbell Michael J
Department of Radiology, University of California, Davis Medical Center, Sacramento, CA, USA.
Department of Surgery, University of California, Davis Medical Center, Sacramento, CA, USA.
Case Rep Endocrinol. 2020 Dec 14;2020:7415762. doi: 10.1155/2020/7415762. eCollection 2020.
Adrenal collision tumors are rare and produce unique diagnostic challenges for clinicians. We report the case of a 45-year-old woman with obesity and diabetes mellitus and an incidentally-discovered adrenal mass containing macroscopic fat, thought to be a myelolipoma. A functional workup confirmed adrenocorticotropic hormone- (ACTH-) independent Cushing's syndrome. The patient underwent a successful laparoscopic adrenalectomy with pathology showing an adrenal collision tumor consisting of an adrenocortical adenoma and a myelolipoma. Postoperatively, the clinical symptoms, body mass index, and hemoglobin A1C all improved. Clinicians should consider a functional workup in patients with radiographically diagnosed myelolipomas as some may prove to be hormonally active collision tumors.
肾上腺碰撞瘤较为罕见，给临床医生带来了独特的诊断挑战。我们报告了一例45岁肥胖且患有糖尿病的女性病例，其偶然发现肾上腺肿块内含有肉眼可见的脂肪，最初认为是肾上腺髓质脂肪瘤。功能检查确诊为促肾上腺皮质激素（ACTH）非依赖性库欣综合征。患者接受了成功的腹腔镜肾上腺切除术，病理显示为肾上腺碰撞瘤，由肾上腺皮质腺瘤和肾上腺髓质脂肪瘤组成。术后，临床症状、体重指数和糖化血红蛋白均有所改善。临床医生应对经影像学诊断为肾上腺髓质脂肪瘤的患者进行功能检查，因为其中一些可能是具有激素活性的碰撞瘤。
