Younes Nada, Bourdeau Isabelle, Olney Harold, Perrotte Paul, Prosmanne Odile, Latour Mathieu, Roberge David, Lacroix André
Division of Endocrinology, and Research Center, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.
Division of Hematology and Medical Oncology, Department of Medicine, and Research Center, Centre hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada.
Endocr Oncol. 2021 Nov 4;1(1):K7-K12. doi: 10.1530/EO-21-0031. eCollection 2021 Jan.
Needle tract seeding is a potential, albeit rare, complication following transcutaneous biopsies, leading to the seeding of tumor cells along the path of the needle. Biopsies of adrenal masses are not routinely recommended and are only indicated, after exclusion of pheochromocytoma, when an adrenal metastasis of a primary extra-adrenal cancer is suspected or when pathological confirmation of inoperable adrenocortical cancer (ACC) may impact treatment. Despite guideline recommendations to avoid primary adrenal biopsy, very few needle tract seeding cases have been reported and none were in the context of an ACC. We report the occurrence of needle tract seeding in a patient following adrenal transcutaneous biopsy leading to ACC abdominal wall recurrence.
Needle tract seeding is a rare complication of transcutaneous biopsy. It may increase morbidity and impact overall survival. It has yet to be documented in adrenocortical carcinoma (ACC).Adrenal masses can be accurately evaluated for malignancy using a combination of conventional and metabolic imaging, such as CT and fluorodeoxyglucose-PET, obviating the need for biopsies.Adrenal mass biopsy is not indicated in ACC unless advanced ACC is diagnosed, and a pathological confirmation would impact management.
针道种植是经皮活检术后一种潜在的并发症，尽管较为罕见，可导致肿瘤细胞沿针道种植。肾上腺肿块活检通常不被推荐，仅在排除嗜铬细胞瘤后，怀疑原发性肾上腺外癌症发生肾上腺转移或无法手术切除的肾上腺皮质癌（ACC）的病理确诊可能影响治疗时才予以考虑。尽管指南建议避免原发性肾上腺活检，但报道的针道种植病例极少，且尚无ACC相关病例。我们报告了1例患者经皮肾上腺活检后发生针道种植，导致ACC腹壁复发。
针道种植是经皮活检的罕见并发症。它可能增加发病率并影响总生存期。肾上腺皮质癌（ACC）中尚未有相关记录。使用传统成像和代谢成像（如CT和氟脱氧葡萄糖-PET）相结合的方法可准确评估肾上腺肿块的恶性程度，从而无需进行活检。除非诊断为晚期ACC且病理确诊会影响治疗管理，否则ACC患者不建议进行肾上腺肿块活检。
