Saraf P, Bharti J N, Elhence P, Pandey H
Department of Pathology, All India Institute of Medical Sciences, Jodhpur, India.
Department of Urology, All India Institute of Medical Sciences, Jodhpur, India.
Acta Endocrinol (Buchar). 2022 Jul-Sep;18(3):379-382. doi: 10.4183/aeb.2022.379.
An adrenal collision tumor is a rare entity. We present a rare combination of giant adrenal ganglioneuroma (GN) and myelolipoma. GN is a rare benign tumor of the adrenal medulla that originates from primitive neural crest cells, while myelolipoma is a benign tumor of the adrenal cortex comprising of mature adipose tissue and blood components.
We present a case of a 52-year-old male who presented with generalized body swelling with episodes of vomiting and diarrhea. There was no history of abdominal pain or any significant history. Routine laboratory investigations and endocrine workup were within normal limits. MRI was performed for unexplained symptoms, and which revealed a solid homogeneous mass measuring 9x7x4.5cm arising from the adrenal gland. A diagnosis of myxoid adrenocortical neoplasm was suggested, and laparoscopic left adrenalectomy was performed based on imaging findings. The final diagnosis of coexisting giant adrenal GN with myelolipoma was made on histopathological examination, which was further confirmed by immunohistochemistry.
Ganglioneuroma coexistence with myelolipoma is a rare finding in the adrenal gland. Therefore, histopathology is imperative in such cases for a definitive diagnosis.
肾上腺碰撞瘤是一种罕见的实体瘤。我们报告了一例罕见的巨大肾上腺神经节神经瘤(GN)与肾上腺髓质脂肪瘤并存的病例。GN是一种罕见的肾上腺髓质良性肿瘤,起源于原始神经嵴细胞,而肾上腺髓质脂肪瘤是一种肾上腺皮质良性肿瘤,由成熟脂肪组织和血液成分组成。
我们报告一例52岁男性,表现为全身肿胀,伴有呕吐和腹泻发作。无腹痛病史或任何重要病史。常规实验室检查和内分泌检查均在正常范围内。因不明原因症状行MRI检查,结果显示肾上腺有一个大小为9×7×4.5cm的实性均匀肿块。初步诊断为黏液性肾上腺皮质肿瘤,根据影像学表现行腹腔镜左肾上腺切除术。组织病理学检查最终诊断为巨大肾上腺GN与肾上腺髓质脂肪瘤并存,免疫组化进一步证实。
神经节神经瘤与肾上腺髓质脂肪瘤并存是肾上腺罕见的表现。因此,在此类病例中,组织病理学检查对于明确诊断至关重要。