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肾上腺复发性上皮样血管平滑肌脂肪瘤：一例报告及文献复习

Recurrent epithelioid angiomyolipoma of the adrenal gland: a case report and literature review.

作者信息

Lin Zeyu, Ding Zheng, Jiang Hongtao

机构信息

The Second Clinical Medical College, Jinan University, Shenzhen, China.

Department of Urology Surgery, Shenzhen People's Hospital, Shenzhen, China.

出版信息

AME Case Rep. 2024 May 9;8:57. doi: 10.21037/acr-23-189. eCollection 2024.

DOI:10.21037/acr-23-189
PMID:39091546
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11292067/
Abstract

BACKGROUND

Epithelioid angiomyolipoma (EAML), a subtype of angiomyolipoma, is distinct. It has a biologic behavior of borderline tumor, a malignant tendency, and a risk of metastasis and recurrence. Adrenal EAML is very rare. It is true that only six cases of adrenal EAML have been documented in the English-language literature.

CASE DESCRIPTION

A 65-year-old man who underwent a laparoscopic left adrenalectomy in July 2022 has adrenal EAML and this is a case report about it. The mass was surrounded by abundant blood vessels and adherence with surround-tissue. Postoperative pathology of the tumor analysis revealed adrenal epithelioid vascular smooth muscle lipoma. The patient underwent left upper abdomen and lumbar pain in July 2022. The enhanced computed tomography (CT) scan of the abdomen showed markedly enhanced masses in and around the left adrenal gland. A second left laparoscopic adrenalectomy was performed under general anesthesia. Postoperative pathology showed two taupe nodules of left adrenal, maximum diameter 0.9 to 1.1 cm. The postoperative pathological diagnosis in combination with immunohistochemistry was EAML. The patient was discharged 10 days later with symptomatic treatment with low molecular heparin.

CONCLUSIONS

Adrenal EAML has a biologic behavior of borderline tumor with malignant potential and a risk of distant metastasis and recurrence. Therefore, radical surgical resection should be considered as its necessary treatment. Long-term postoperative follow-up is an important part of the treatment.

摘要

背景

上皮样血管平滑肌脂肪瘤（EAML）是血管平滑肌脂肪瘤的一种亚型，具有独特性。它具有交界性肿瘤的生物学行为、恶性倾向以及转移和复发风险。肾上腺EAML非常罕见。英文文献中仅记载了6例肾上腺EAML病例。

病例描述

一名65岁男性于2022年7月接受了腹腔镜左肾上腺切除术，患有肾上腺EAML，本文为关于该病例的报告。肿块被丰富的血管环绕，并与周围组织粘连。肿瘤分析的术后病理显示为肾上腺上皮样血管平滑肌脂肪瘤。该患者于2022年7月出现左上腹及腰部疼痛。腹部增强计算机断层扫描（CT）显示左肾上腺及其周围有明显强化的肿块。在全身麻醉下进行了第二次腹腔镜左肾上腺切除术。术后病理显示左肾上腺有两个灰褐色结节，最大直径0.9至1.1厘米。术后病理诊断结合免疫组化结果为EAML。患者在接受低分子肝素对症治疗10天后出院。

结论

肾上腺EAML具有交界性肿瘤的生物学行为，有恶性潜能及远处转移和复发风险。因此，应考虑将根治性手术切除作为其必要的治疗方法。术后长期随访是治疗的重要组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/879c/11292067/e43d10acdcdb/acr-08-23-189-f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/879c/11292067/9fc9d0b28a63/acr-08-23-189-f1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/879c/11292067/e43d10acdcdb/acr-08-23-189-f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/879c/11292067/9fc9d0b28a63/acr-08-23-189-f1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/879c/11292067/74a098f0d076/acr-08-23-189-f3.jpg
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Advancements in the diagnosis and treatment of renal epithelioid angiomyolipoma: A narrative review.肾上皮样血管平滑肌脂肪瘤诊断与治疗的进展：一项叙述性综述。
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Angiomyolipoma of the Adrenal Glands.肾上腺血管平滑肌脂肪瘤
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