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肝脏内异位肾上腺导致肝细胞癌误诊:一例报告

Ectopic adrenal gland in the liver leading to a misdiagnosis of hepatocellular carcinoma: A case report.

作者信息

Qin Min-Qiu, Zhao Yi-Peng, Xie Ju-Ping

机构信息

Department of Health and Rehabilitation, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China.

Department of Pathology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China.

出版信息

World J Hepatol. 2025 Aug 27;17(8):108443. doi: 10.4254/wjh.v17.i8.108443.

Abstract

BACKGROUND

Adrenal ectopia is a rare condition in which adrenal tissue is found in an abnormal location, often posing diagnostic challenges. Although generally considered benign, it can present as hepatic or other organ lesions, mimicking malignant tumors. In the liver, ectopic adrenal tissue can closely resemble hepatocellular carcinoma or metastatic disease, potentially leading to unnecessary aggressive treatments such as surgery or chemotherapy. Consequently, a high index of suspicion is essential to avoid misdiagnosis and ensure appropriate management.

CASE SUMMARY

In this case report, we present a 53-year-old male with ectopic adrenal tissue in the liver, mimicking a potential hepatic malignancy. Based on computed tomography and magnetic resonance imaging findings, which suggested a malignant liver lesion and a left adrenal adenoma, the patient underwent laparoscopic partial hepatectomy under general anesthesia. Intraoperatively, no signs of liver cirrhosis were observed. An intraoperative ultrasound identified a 1.2 cm hypoechoic nodule in segment 7 of the liver. Dissection of the right adrenal gland revealed that the nodule had infiltrated the hepatic parenchyma, confirming the presence of ectopic adrenal tissue. Frozen section pathology revealed proliferating adrenal tissue. The patient recovered smoothly and was discharged 10 days postoperatively.

CONCLUSION

This case report underscores the importance of considering adrenal ectopia in the differential diagnosis of liver lesions, especially when imaging findings suggest malignancy.

摘要

背景

肾上腺异位是一种罕见的情况,即在异常位置发现肾上腺组织,这常常给诊断带来挑战。尽管通常被认为是良性的,但它可能表现为肝脏或其他器官的病变,酷似恶性肿瘤。在肝脏中,异位肾上腺组织可能与肝细胞癌或转移性疾病极为相似,可能导致不必要的激进治疗,如手术或化疗。因此,高度的怀疑指数对于避免误诊和确保恰当的管理至关重要。

病例摘要

在本病例报告中,我们呈现了一名53岁男性,其肝脏存在异位肾上腺组织,酷似潜在的肝脏恶性肿瘤。基于计算机断层扫描和磁共振成像结果,提示为肝脏恶性病变和左侧肾上腺腺瘤,该患者在全身麻醉下接受了腹腔镜部分肝切除术。术中未观察到肝硬化迹象。术中超声在肝脏7段发现一个1.2厘米的低回声结节。对右侧肾上腺进行解剖后发现该结节已浸润肝实质,证实存在异位肾上腺组织。冰冻切片病理显示肾上腺组织增生。患者恢复顺利,术后10天出院。

结论

本病例报告强调了在肝脏病变的鉴别诊断中考虑肾上腺异位的重要性,尤其是当影像学结果提示为恶性时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dec5/12400313/21cf0790c277/wjh-17-8-108443-g001.jpg

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