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腹腔镜下切除主动脉分叉处的腹主动脉旁肿物：尾肠囊肿的非典型表现

Laparoscopic Resection of Para-Aortic Mass at the Aortic Bifurcation: An Atypical Presentation of a Tailgut Cyst.

作者信息

Wang Andy, Guart Jiddu A, Li Danielle, Taros Trenton, Cui Hongyi

机构信息

Surgery, University of Massachusetts Chan Medical School, Worcester, USA.

General Surgery, University of Massachusetts Chan Medical School, Worcester, USA.

出版信息

Cureus. 2024 Jun 14;16(6):e62391. doi: 10.7759/cureus.62391. eCollection 2024 Jun.

DOI:10.7759/cureus.62391
PMID:39006679
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11246758/
Abstract

We review the case of a 43-year-old white male who presented with an enlarging pulsatile mass in the periumbilical region. Diagnostic imaging revealed an 8-cm heterogeneous mass abutting the left iliac artery at the aortic bifurcation. Due to the patient's persistently elevated blood pressure and elevated serum and urine catecholamines, a neuroendocrine tumor was suspected. Laparoscopic resection was performed and was well tolerated. However, the mass was characterized as a tailgut cyst upon pathological examination. This case highlights the utility of laparoscopy for the removal of large para-aortic masses, which can be achieved in a safe fashion by an experienced surgeon. In addition, this case highlights the importance of differential diagnoses in surgeries due to the occurrence of unexpected outcomes.

摘要

我们回顾了一名43岁白人男性的病例，该患者脐周区域出现一个不断增大的搏动性肿块。诊断性影像学检查显示，在主动脉分叉处有一个8厘米的异质性肿块紧邻左髂动脉。由于患者血压持续升高以及血清和尿儿茶酚胺升高，怀疑为神经内分泌肿瘤。进行了腹腔镜切除术，患者耐受性良好。然而，病理检查显示该肿块为尾肠囊肿。该病例突出了腹腔镜在切除大的主动脉旁肿块方面的实用性，经验丰富的外科医生可以安全地完成。此外，该病例还突出了由于出现意外结果，鉴别诊断在手术中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/f095f1fc013a/cureus-0016-00000062391-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/4737abfab004/cureus-0016-00000062391-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/54361d877645/cureus-0016-00000062391-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/b74ea373a0b3/cureus-0016-00000062391-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/f9b572b4d77e/cureus-0016-00000062391-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/78b3c8e41a4c/cureus-0016-00000062391-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/3dbd0dc44ce9/cureus-0016-00000062391-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/313fb6d379f1/cureus-0016-00000062391-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/fdd528d9f32f/cureus-0016-00000062391-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/f095f1fc013a/cureus-0016-00000062391-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/4737abfab004/cureus-0016-00000062391-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/54361d877645/cureus-0016-00000062391-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/b74ea373a0b3/cureus-0016-00000062391-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/f9b572b4d77e/cureus-0016-00000062391-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/78b3c8e41a4c/cureus-0016-00000062391-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/3dbd0dc44ce9/cureus-0016-00000062391-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/313fb6d379f1/cureus-0016-00000062391-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/fdd528d9f32f/cureus-0016-00000062391-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e5d/11246758/f095f1fc013a/cureus-0016-00000062391-i09.jpg

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本文引用的文献

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Urinary Free Metanephrines for Diagnosis of Pheochromocytoma and Paraganglioma.尿游离甲氧基肾上腺素用于嗜铬细胞瘤和副神经节瘤的诊断。
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Pheochromocytomas and Paragangliomas.嗜铬细胞瘤和副神经节瘤。
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Pheochromocytoma and Paraganglioma.嗜铬细胞瘤和副神经节瘤。
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Tailgut cyst: report of three cases and review of the literature.尾肠囊肿：三例报告并文献复习
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Ann Ital Chir. 2016 Nov 3;87:S2239253X16025871.
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Comparison of diagnostic accuracy of urinary free metanephrines, vanillyl mandelic Acid, and catecholamines and plasma catecholamines for diagnosis of pheochromocytoma.尿游离间甲肾上腺素、香草扁桃酸、儿茶酚胺与血浆儿茶酚胺对嗜铬细胞瘤诊断的诊断准确性比较。
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