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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.

DOI:10.7759/cureus.53619
PMID:38449972
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10915715/
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/10915715/4415e7ee578d/cureus-0016-00000053619-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926d/10915715/8ab64ad3e318/cureus-0016-00000053619-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926d/10915715/4bacea10b0f2/cureus-0016-00000053619-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926d/10915715/4415e7ee578d/cureus-0016-00000053619-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926d/10915715/8ab64ad3e318/cureus-0016-00000053619-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926d/10915715/4bacea10b0f2/cureus-0016-00000053619-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926d/10915715/4415e7ee578d/cureus-0016-00000053619-i03.jpg

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本文引用的文献

1
Adrenal Schwannoma: Case Description and Diagnostic Pointers of a Rare Disease.肾上腺神经鞘瘤:一种罕见疾病的病例描述及诊断要点
Cureus. 2023 Feb 1;15(2):e34485. doi: 10.7759/cureus.34485. eCollection 2023 Feb.
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Clinical presentation, management, and research progress of adrenal schwannoma.肾上腺神经鞘瘤的临床表现、管理及研究进展
Front Surg. 2022 Jul 26;9:931998. doi: 10.3389/fsurg.2022.931998. eCollection 2022.
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Adrenal Schwannoma: A Case Report.肾上腺神经鞘瘤:一例报告
Int Med Case Rep J. 2021 Sep 7;14:617-620. doi: 10.2147/IMCRJ.S311777. eCollection 2021.
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Clinical features and outcomes of adrenal schwannoma: a study of 13 cases from a single centre.肾上腺神经鞘瘤的临床特征与预后:来自单一中心的13例病例研究
Endocr Connect. 2021 May 19;10(5):543-549. doi: 10.1530/EC-21-0062.
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Pitfalls and differential diagnosis on adrenal lesions: current concepts in CT/MR imaging: a narrative review.肾上腺病变的陷阱与鉴别诊断:CT/MR成像的当前概念:一篇叙述性综述
Gland Surg. 2020 Dec;9(6):2331-2342. doi: 10.21037/gs-20-559.
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Adrenal schwannoma: a case report.肾上腺神经鞘瘤:一例报告
BJR Case Rep. 2020 Feb 12;6(1):20190044. doi: 10.1259/bjrcr.20190044. eCollection 2020 Mar.
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Management of incidental adrenal masses: an update.意外肾上腺肿块的处理:更新。
Abdom Radiol (NY). 2020 Apr;45(4):892-900. doi: 10.1007/s00261-019-02149-2.
8
Management of Incidental Adrenal Masses: A White Paper of the ACR Incidental Findings Committee.偶发肾上腺肿块的管理:美国放射学会偶发发现委员会白皮书
J Am Coll Radiol. 2017 Aug;14(8):1038-1044. doi: 10.1016/j.jacr.2017.05.001. Epub 2017 Jun 23.
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Adrenal lesions: spectrum of imaging findings with emphasis on multi-detector computed tomography and magnetic resonance imaging.肾上腺病变:影像学表现谱,重点关注多排螺旋计算机断层扫描和磁共振成像
J Clin Imaging Sci. 2013 Dec 31;3:61. doi: 10.4103/2156-7514.124088. eCollection 2013.
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Arch Pathol Lab Med. 2013 Jul;137(7):1009-14. doi: 10.5858/arpa.2012-0291-RS.