Nishida S, Tanimura A, Takasaki S, Nagaoka S, Fukueda M, Ikeda S, Matsuo K, Akao M, Tokunaga M
Department of Surgery, Shimonoseki City Hospital, Yamaguchi, Japan.
Surg Today. 1995;25(5):455-7. doi: 10.1007/BF00311827.
This report describes the case of a 48-year-old woman found to have a leiomyoma of the left adrenal gland after presenting with anemia and hypertension. An upper gastrointestinal series revealed a mass in the posterior region of the body that distorted the stomach. A computed tomography (CT) scan showed a well-circumscribed mass with a high-density outline in the left adrenal gland, and magnetic resonance imaging (MRI) revealed a homogeneous mass. Multiple catheter samplings of vena cava blood revealed a slight elevation of epinephrine and norepinephrine in the left adrenal vein and the left renal vein. Thus, asymptomatic pheochromocytoma of the left adrenal gland was highly suspected as a preoperative diagnosis and a left adrenalectomy was performed. However, histologic examination subsequently revealed findings suggestive of leiomyoma of the adrenal gland, which was confirmed by electron microscopy. The patient's postoperative course was uneventful and she has remained free from any further symptoms.
本报告描述了一名48岁女性的病例,该患者在出现贫血和高血压后被发现左肾上腺有平滑肌瘤。上消化道造影显示胃体后部有一肿块,使胃变形。计算机断层扫描(CT)显示左肾上腺有一个边界清晰、轮廓高密度的肿块,磁共振成像(MRI)显示为均匀肿块。对腔静脉血进行多次导管采样显示,左肾上腺静脉和左肾静脉中的肾上腺素和去甲肾上腺素略有升高。因此,术前高度怀疑为左肾上腺无症状嗜铬细胞瘤,并进行了左肾上腺切除术。然而,组织学检查随后显示出提示肾上腺平滑肌瘤的结果,电子显微镜检查证实了这一点。患者术后恢复顺利,未再出现任何进一步症状。