Yang Qin, Zhu Qiang, You Yuekai, Li Mingzhen, Zhang Kun
Department of General Surgery, Fuzhou First General Hospital affiliated with Fujian Medical University, Fuzhou, China; Department of General Surgery, Xinjiang Uyghur Autonomous Region Changji Hui Autonomous Prefecture Qitai County Peoples Hospital, Xinjiang, China.
Department of General Surgery, Fuzhou First General Hospital affiliated with Fujian Medical University, Fuzhou, China.
Int J Surg Case Rep. 2024 Sep;122:110045. doi: 10.1016/j.ijscr.2024.110045. Epub 2024 Jul 23.
Adrenal myelolipoma (AML) is a rare, benign neoplasm of the adrenal gland often found incidentally during medical examinations for unrelated conditions. This case study presents a 39-year-old male patient with a particularly large AML, weighing 11 kg upon surgical removal, potentially making it the largest documented tumor in medical literature.
A 39-year-old male presenting with abdominal distension and clinical manifestations of Cushing syndrome was discovered to have sizable adrenal masses. Initial pre-operative fine-needle aspiration biopsy indicated lipogenic tumors, however, subsequent post-operative pathological analysis revealed the presence of adrenal myelolipoma. Following surgery, the patient developed an adrenal crisis but responded well to glucocorticoid therapy and made a successful recovery.
In contrast to previously documented instances, the present case potentially the most extensive case of its kind reported thus far. AML is an uncommon benign tumor of the adrenal gland, with diagnostic and therapeutic challenges arising from its resemblance to other adrenal neoplasms. Owing to the inherent limitations of fine needle biopsy and the propensity for misdiagnosis, the adrenal origin of the tumor was not initially considered, leading to postoperative adrenal crisis in the patient.
AML, a rare tumor, poses challenges in accurate diagnosis. Comprehensive imaging studies are essential to differentiate it from other neoplasms. Rigorous preoperative and postoperative pathological evaluations are crucial to avoid diagnostic errors. Additionally, thorough endocrinological assessments before and after surgery are imperative for early detection and management of any associated endocrine abnormalities.
肾上腺髓脂肪瘤（AML）是一种罕见的肾上腺良性肿瘤，常在因无关疾病进行医学检查时偶然发现。本病例研究介绍了一名39岁男性患者，患有一个特别大的AML，手术切除时重达11千克，可能是医学文献中记录的最大肿瘤。
一名39岁男性，出现腹胀和库欣综合征的临床表现，被发现有较大的肾上腺肿块。术前最初的细针穿刺活检显示为脂肪生成性肿瘤，但随后的术后病理分析显示存在肾上腺髓脂肪瘤。手术后，患者发生肾上腺危象，但对糖皮质激素治疗反应良好，成功康复。
与先前记录的病例相比，本病例可能是迄今为止报道的此类最广泛的病例。AML是一种罕见的肾上腺良性肿瘤，由于其与其他肾上腺肿瘤相似，在诊断和治疗方面存在挑战。由于细针活检的固有局限性和误诊倾向，肿瘤的肾上腺起源最初未被考虑，导致患者术后出现肾上腺危象。
AML是一种罕见肿瘤，在准确诊断方面存在挑战。全面的影像学研究对于将其与其他肿瘤区分开来至关重要。严格的术前和术后病理评估对于避免诊断错误至关重要。此外，手术前后进行全面的内分泌评估对于早期发现和管理任何相关的内分泌异常至关重要。
