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肾上腺神经鞘瘤病例报告:肾上腺肿块谱中的一种罕见模仿者。

Case Report on Adrenal Schwannomas: A Rare Mimic in the Spectrum of Adrenal Masses.

作者信息

Garg Pankhuri, Dharamshi Jay D, Dhale Abhijit, Pendkar Ruturaj, Hatwar Ghanshyam

机构信息

General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

Urology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.

出版信息

Cureus. 2024 Feb 5;16(2):e53619. doi: 10.7759/cureus.53619. eCollection 2024 Feb.

Abstract

Adrenal schwannomas are exceptionally rare tumors affecting about 0.2%, originating from the adrenal gland, presenting diagnostic challenges due to their nonspecific clinical features and overlapping radiological characteristics with other adrenal masses. Here, we report the case of a 49-year-old female with no significant medical history presenting with diffuse abdominal pain. Imaging studies, including contrast-enhanced computerized tomography (CECT), revealed a well-defined mass within the right adrenal gland. Given inconclusive radiological findings and persistent symptoms, surgical exploration was performed, leading to the identification and resection of the mass. Microscopic examination, including immunohistochemistry, confirmed the schwannomatous origin of the tumor. The final diagnosis of an adrenal schwannoma was established after a histopathological examination. Postoperatively, the patient was treated with antibiotics and discharged on oral antibiotics after suture removal on advised follow-up after 15 days. This case highlights the diagnostic complexities associated with adrenal schwannomas and emphasizes the necessity of surgical intervention for conclusive diagnosis. The report aims to contribute to the limited literature on adrenal schwannomas, enhancing our understanding of their clinical presentation and reinforcing the importance of a multidisciplinary approach in their diagnosis and management.

摘要

肾上腺神经鞘瘤是极为罕见的肿瘤,发病率约为0.2%,起源于肾上腺,因其非特异性临床特征以及与其他肾上腺肿块重叠的放射学特征而带来诊断挑战。在此,我们报告一例49岁无重大病史的女性,其表现为弥漫性腹痛。包括增强计算机断层扫描(CECT)在内的影像学检查显示右肾上腺内有一个边界清晰的肿块。鉴于放射学检查结果不明确且症状持续存在,遂进行手术探查,从而识别并切除了该肿块。包括免疫组织化学在内的显微镜检查证实了肿瘤的神经鞘瘤起源。经组织病理学检查后确诊为肾上腺神经鞘瘤。术后,患者接受了抗生素治疗,并在术后15天拆线时口服抗生素后出院,并按建议进行随访。该病例突出了肾上腺神经鞘瘤相关的诊断复杂性,并强调了手术干预以进行确诊的必要性。本报告旨在为关于肾上腺神经鞘瘤的有限文献做出贡献,增进我们对其临床表现的理解,并强化多学科方法在其诊断和管理中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926d/10915715/8ab64ad3e318/cureus-0016-00000053619-i01.jpg

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