Lameir Hussein Mohammed, Alkhateeb Shams O, Kolleri Jouhar J, Saleem Abu-Dayeh Ala', Murshed Khaled, Sherif Mahmood Nabil
Clinical Imaging Department, Hamad Medical Corporation, Doha, QAT.
Medical Education Department, Hamad Medical Corporation, Doha, QAT.
Cureus. 2024 Dec 13;16(12):e75648. doi: 10.7759/cureus.75648. eCollection 2024 Dec.
Adrenal incidentalomas are increasingly identified through advanced imaging, posing diagnostic challenges due to their varied benign and malignant nature. We present the case of a 29-year-old male who, during evaluation for left renal colic, was found to have a 5.5 cm heterogeneous right adrenal mass on non-contrast CT, initially suggestive of a myelolipoma. Subsequent contrast-enhanced CT supported this diagnosis. However, due to the size of the mass and potential complications, the patient underwent a robotic-assisted adrenalectomy. Histopathological examination unexpectedly revealed a 6.5 cm adrenal ganglioneuroma. This case highlights the difficulties in accurately diagnosing adrenal incidentalomas based solely on imaging, as the features of ganglioneuromas and myelolipomas can occasionally overlap significantly. Ultimately, while imaging plays a critical role in initial assessment, definitive diagnosis often requires histological analysis, underscoring the challenges posed by adrenal incidentalomas in clinical practice.
肾上腺偶发瘤越来越多地通过先进的影像学检查被发现，由于其良恶性各异，给诊断带来了挑战。我们报告一例29岁男性病例，该患者在评估左肾绞痛时，非增强CT发现右侧肾上腺有一个5.5厘米的异质性肿块，最初提示为肾上腺髓质脂肪瘤。随后的增强CT支持了这一诊断。然而，由于肿块大小及潜在并发症，患者接受了机器人辅助肾上腺切除术。组织病理学检查意外发现是一个6.5厘米的肾上腺神经节细胞瘤。该病例凸显了仅基于影像学准确诊断肾上腺偶发瘤的困难，因为神经节细胞瘤和肾上腺髓质脂肪瘤的特征有时会有显著重叠。最终，虽然影像学在初始评估中起着关键作用，但明确诊断通常需要组织学分析，这突出了肾上腺偶发瘤在临床实践中带来的挑战。
