Ito Kana, Yamashita Ryo, Sakura Yuma, Shinsaka Hideo, Nakamura Masafumi, Matsuzaki Masato, Niwakawa Masashi, Hiraki Tsubasa
Division of Urology Shizuoka Cancer Center Shizuoka Japan.
Department of Diagnostic Pathology Shizuoka Cancer Center Shizuoka Japan.
IJU Case Rep. 2024 Oct 11;8(1):15-18. doi: 10.1002/iju5.12792. eCollection 2025 Jan.
Adrenal myelolipomas are uncommon benign adrenal tumors, which mostly occur unilaterally. We describe a rare case of giant bilateral adrenal myelolipoma mistaken for retroperitoneal liposarcoma.
A 49-year-old man developed fever, left flank pain, and a large mass in his left abdomen. Plain computed tomography showed a 23-cm mass with fat-containing components in the retroperitoneal cavity, suggestive of retroperitoneal liposarcoma. A similar 9-cm mass was observed in the right adrenal gland, suggesting adrenal metastasis. With a clinical diagnosis of retroperitoneal liposarcoma, we administered preoperative radiation therapy and performed a bilateral tumor resection. On postoperative day 9, a surgical site infection occurred, necessitating incisional drainage and the administration of intravenous antibiotics. The histopathological diagnosis was bilateral myelolipoma of the adrenal glands.
In cases of bilateral retroperitoneal tumors with a large fat component, adrenal myelolipoma should be considered in the differential diagnosis to avoid overtreatment.
肾上腺髓脂肪瘤是一种罕见的肾上腺良性肿瘤，大多单侧发生。我们描述了一例罕见的双侧巨大肾上腺髓脂肪瘤被误诊为腹膜后脂肪肉瘤的病例。
一名49岁男性出现发热、左侧胁腹疼痛及左腹部巨大肿块。普通计算机断层扫描显示腹膜后腔有一个23厘米的含脂肪成分肿块，提示腹膜后脂肪肉瘤。右侧肾上腺发现一个类似的9厘米肿块，提示肾上腺转移。临床诊断为腹膜后脂肪肉瘤，我们给予术前放射治疗并进行双侧肿瘤切除术。术后第9天发生手术部位感染，需要切开引流并静脉注射抗生素。组织病理学诊断为双侧肾上腺髓脂肪瘤。
对于双侧腹膜后有大量脂肪成分的肿瘤，鉴别诊断时应考虑肾上腺髓脂肪瘤，以避免过度治疗。
