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肾上腺神经鞘瘤在一名患有子宫肌瘤和胆结石的患者中作为偶发瘤出现:一例罕见病例报告。

Adrenal Schwannoma Presenting as an Incidentaloma in a Patient with Uterine Fibroids and Cholelithiasis: a Rare Case Report.

作者信息

Singh Utkarsh, Roy Shubhajeet, Gaurav Kushagra, Anand Akshay, Qayoom Sumaira, Sonkar Abhinav A

机构信息

Faculty of Medical Sciences, King George's Medical University, Lucknow, Uttar Pradesh India.

Department of General Surgery, King George's Medical University, Shah Mina Shah Road, Chowk, Lucknow, 226003 Uttar Pradesh India.

出版信息

Indian J Surg Oncol. 2024 Sep;15(Suppl 3):395-399. doi: 10.1007/s13193-024-01969-z. Epub 2024 May 29.

Abstract

Schwannomas, which are benign mesenchymal tumors derived from Schwann cells, are common in the central nervous system. While they are commonly seen in the extremities and head-neck area, their presence in visceral organs, particularly the adrenals, is uncommon. Adrenal schwannomas are frequently discovered incidentally, offering a diagnostic difficulty because of their uncommon presentation. A 46-year-old woman initially sought treatment for symptoms related to uterine fibroids and biliary stones. Diagnostic imaging uncovered an adrenal incidentaloma, necessitating a laparoscopic right adrenalectomy. The mass was determined to be an adrenal schwannoma based on its spindle-shaped cells and S-100 immunohistochemistry positivity. The patient's symptoms improved, and she was discharged with stable vital signs. Preoperative diagnosis of adrenal schwannomas is difficult and requires histological confirmation. When diagnosing non-secreting adrenal tumors with unusual radiology, surgeons should investigate for schwannoma. Post-resection adrenal schwannoma follow-up studies are scarce; however, they imply a low risk of recurrence or metastasis.

摘要

神经鞘瘤是源自施万细胞的良性间叶组织肿瘤,在中枢神经系统中较为常见。虽然它们常见于四肢和头颈部区域,但在内脏器官,尤其是肾上腺中出现的情况并不常见。肾上腺神经鞘瘤常常是偶然发现的,因其表现不常见而带来诊断困难。一名46岁女性最初因子宫肌瘤和胆结石相关症状寻求治疗。诊断性影像学检查发现了一个肾上腺偶发瘤,需要进行腹腔镜右肾上腺切除术。根据其梭形细胞和S-100免疫组化阳性结果,该肿块被确定为肾上腺神经鞘瘤。患者症状改善,生命体征平稳后出院。肾上腺神经鞘瘤的术前诊断困难,需要组织学证实。当通过不寻常的放射学表现诊断非分泌性肾上腺肿瘤时,外科医生应排查神经鞘瘤。肾上腺神经鞘瘤切除术后的随访研究较少;然而,这些研究表明其复发或转移风险较低。

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本文引用的文献

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Approach to the Patient With Adrenal Incidentaloma.肾上腺意外瘤患者的处理方法。
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