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肾上腺畸胎瘤 1 例:巨大但易误诊。

A Case Report of Adrenal Teratoma: Huge but Easy to Misdiagnose.

机构信息

Department of Urology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

出版信息

Urol Int. 2022;106(11):1195-1200. doi: 10.1159/000526218. Epub 2022 Oct 11.

Abstract

Primary adrenal teratoma is a rare lesion with a high misdiagnosis rate. In view of the fact that adrenal teratoma and adrenal gland are often inseparable, the removal of the affected adrenal gland seems inevitable. Thus, it is necessary for clinicians to differentiate adrenal teratoma from common adrenal lipoma diseases, such as adrenal angiomyolipoma, adrenal myelolipoma, lipoma, gangliocytoma, and so on. In this study, we reported the clinical and pathologic features of 7 patients surgically treated for adrenal mature teratomas from 2007 to 2020 in our hospital. We compared the clinical characteristics and surgical management in literature review cases with our cases. All patients were females and underwent open adrenalectomy or laparoscopic adrenalectomy, respectively. In our cases, there was no recurrence during the longest follow-up of 13 years. Adrenal teratoma is rare and easy to ignore. And once misdiagnosed, the surgeon may need to adjust the operation temporarily, extend the operation time and finally increase the operative risks. Our aim is mainly to help clinicians to raise awareness of adrenal teratomas, improve the diagnosis rates and optimize the treatment decision-making of this disease.

摘要

原发性肾上腺畸胎瘤是一种罕见的病变,误诊率很高。鉴于肾上腺畸胎瘤和肾上腺通常难以区分,因此切除受影响的肾上腺似乎是不可避免的。因此,临床医生有必要将肾上腺畸胎瘤与常见的肾上腺脂肪瘤疾病(如肾上腺血管平滑肌脂肪瘤、肾上腺髓样脂肪瘤、脂肪瘤、神经节细胞瘤等)区分开来。本研究报告了 2007 年至 2020 年我院 7 例经手术治疗的成熟性肾上腺畸胎瘤患者的临床和病理特征。我们比较了文献复习病例与我院病例的临床特征和手术处理。所有患者均为女性,分别接受了开放肾上腺切除术或腹腔镜肾上腺切除术。在我们的病例中,最长随访 13 年无复发。肾上腺畸胎瘤罕见且易被忽视。一旦误诊,外科医生可能需要临时调整手术,延长手术时间,最终增加手术风险。我们的目的主要是帮助临床医生提高对肾上腺畸胎瘤的认识,提高诊断率,并优化这种疾病的治疗决策。

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