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年轻人的肾上腺肿瘤:病例报告和文献回顾。

Adrenal Tumors in Young Adults: Case Reports and Literature Review.

机构信息

Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland.

Department of Radiology, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland.

出版信息

Medicina (Kaunas). 2022 May 30;58(6):746. doi: 10.3390/medicina58060746.

DOI:10.3390/medicina58060746
PMID:35744009
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9230179/
Abstract

The current high detection rate of adrenal tumors (4-10% of general population) is attributable to a widespread use of variety of imaging studies, especially a computed tomography. Most of them represent clinically silent and biologically indolent incidentalomas, but some adrenal tumors may pose a significant clinical challenge. Thus, in every patient with an adrenal tumor, a decision on further management is made after careful hormonal and radiological evaluation. All hormonally active tumors and those with radiological features suggesting malignancy are qualified for surgery. Approximately 80% of adrenal tumors are adrenocortical adenomas, hypertrophy, or nodular adrenocortical hyperplasia. Other histopathological diagnoses include pheochromocytoma, adrenocortical carcinoma, metastases, mesenchymal tumors, lymphomas, cysts, and ganglioneuromas. Adrenal tumors are more commonly diagnosed and better studied in elderly patients. In younger patients, under 40 years old, focal adrenal lesions are relatively rare, and histological distribution of diagnoses differs from that in elderly individuals. Younger patients are more likely to display endocrine symptoms, which raise the suspicion of an adrenal mass. In the current study, we present a case series of seven adrenal tumors occurring in young patients. The cases presented below, along with the literature review, demonstrate that the diagnosis and treatment of adrenal tumors are crucial due to endocrinopathy-derived complications and a potential risk of malignancy.

摘要

当前,由于广泛应用各种影像学研究(尤其是计算机断层扫描),肾上腺肿瘤的检出率(占普通人群的 4-10%)较高。其中大多数为无临床症状且生物学惰性的偶发瘤,但有些肾上腺肿瘤可能会带来重大的临床挑战。因此,在每一位肾上腺肿瘤患者中,均需在仔细进行激素和影像学评估后,再决定进一步的处理方案。所有具有激素活性的肿瘤和影像学提示恶性特征的肿瘤均适合手术治疗。约 80%的肾上腺肿瘤为肾上腺皮质腺瘤、增生或结节性肾上腺皮质增生。其他组织病理学诊断包括嗜铬细胞瘤、肾上腺皮质癌、转移瘤、间叶肿瘤、淋巴瘤、囊肿和神经节瘤。在老年患者中,肾上腺肿瘤更为常见且研究也更为深入。在 40 岁以下的年轻患者中,局灶性肾上腺病变相对较少,且诊断的组织学分布与老年患者不同。年轻患者更可能出现内分泌症状,这会增加对肾上腺肿块的怀疑。在本研究中,我们报告了 7 例发生在年轻患者中的肾上腺肿瘤病例系列。下文报告的病例以及文献复习表明,由于内分泌病变相关的并发症和潜在的恶性风险,肾上腺肿瘤的诊断和治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/4ef71c78513a/medicina-58-00746-g013.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/e005d649b854/medicina-58-00746-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/ed694b491046/medicina-58-00746-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/2862b18d1c89/medicina-58-00746-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/0475a057f426/medicina-58-00746-g011.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/4ef71c78513a/medicina-58-00746-g013.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/3126b7463b27/medicina-58-00746-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/2049d76b1562/medicina-58-00746-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/69083e2dcaaf/medicina-58-00746-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/f44d67f18740/medicina-58-00746-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/513cef0dc75e/medicina-58-00746-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/610aa44787d6/medicina-58-00746-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/a5e4f2f97428/medicina-58-00746-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/e005d649b854/medicina-58-00746-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/ed694b491046/medicina-58-00746-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/2862b18d1c89/medicina-58-00746-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/0475a057f426/medicina-58-00746-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/44ad023e5111/medicina-58-00746-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb1/9230179/4ef71c78513a/medicina-58-00746-g013.jpg

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