机器人辅助肾上腺手术后诊断为交界性不确定恶性潜能的嗜酸细胞瘤肾上腺皮质肿瘤病例报告。
Oncocytic adrenocortical neoplasm of borderline uncertain malignant potential diagnosed after robot-assisted adrenalectomy case report.
机构信息
Department of Urology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
出版信息
BMC Urol. 2023 Apr 15;23(1):60. doi: 10.1186/s12894-023-01238-1.
BACKGROUND
Adrenal incidentalomas are radiologically discovered tumors that represent a variety of pathologies, with the diagnosis clinched only on surgical pathology. These tumors may be clinically monitored, but triggers for surgery include size > 4 cm, concerning features on radiology, or hormonally functioning. Adrenal oncocytic neoplasms (AONs) are notably rare and typically nonfunctional tumors that are discovered as incidentalomas and exist on a spectrum of malignant potential.
CASE PRESENTATION
We discovered an exceptionally large (15 cm in the greatest dimension) incidentaloma in a 73-year-old man with left back pain and he was treated with robotic-assisted adrenalectomy. Surgical pathology was consistent with AON of borderline uncertain malignant potential; adjuvant mitotane and radiation were omitted based on shared decision-making.
CONCLUSION
Large AONs are rare, usually benign tumors that can be safely treated with robotic-assisted adrenalectomy. Surgical pathology is the crux of diagnosis and post-operative management, as it informs both the initiation of adjuvant therapy and the stringency of post-operative surveillance.
背景
肾上腺意外瘤是影像学发现的肿瘤，代表了多种病理学特征，只有手术病理学才能确诊。这些肿瘤可以临床监测，但手术指征包括肿瘤直径>4cm、影像学上有可疑特征或功能性肿瘤。肾上腺嗜酸细胞瘤（AON）是非常罕见的，通常为无功能性肿瘤，作为意外瘤被发现，其恶性潜能存在一定的范围。
病例介绍
我们在一名 73 岁男性中发现了一个巨大的（最大径 15cm）意外瘤，他有左侧背痛，接受了机器人辅助肾上腺切除术。手术病理学符合交界性不确定恶性潜能的 AON；根据共同决策，省略了辅助米托坦和放疗。
结论
大的 AON 罕见，通常为良性肿瘤，可通过机器人辅助肾上腺切除术安全治疗。手术病理学是诊断和术后管理的关键，它不仅决定了辅助治疗的开始，还决定了术后监测的严格程度。
Zotero 插件