Abe T, Kawamura S, Aoki H, Kubo T, Monoma N
Department of Urology, Iwate Prefectural Miyako Hospital.
Nihon Hinyokika Gakkai Zasshi. 1994 Oct;85(10):1563-6. doi: 10.5980/jpnjurol1989.85.1563.
Lipoma of the adrenal gland is extremely rare. This condition was first described in 1988 and only seven cases have been reported to date. We have experienced a case of adrenal lipoma which was thought to be adrenal myelolipoma on computed tomography (CT). A 56-year-old man was admitted to our department with a complaint of left abdominal pain. Sonography revealed a hyperechoic mass above the left kidney, and a CT scan revealed the mass to be comprised sharply marginated and an inhomogeneous structure. The tumor was comprised of areas of different density including a fatty tissue portion. These findings were strongly suggestive of adrenal myelolipoma or liposarcoma, and a left adrenalectomy was performed. Macroscopically, the tumor was consisted of yellow fatty mass and necrotic areas, which were surrounded by thin fibrous capsule. The adrenal gland was compressed at the bottom of the tumor. The weight of tumor was 290 g. Microscopically, the tumor consisted of large fat cells in direct contact with adrenal cortical cells, and it was then diagnosed adrenal lipoma. Postoperatively, the patient no longer experienced left abdominal pain and there has been no recurrence in the 31 months since the operation.
肾上腺脂肪瘤极为罕见。这种情况于1988年首次被描述，迄今为止仅报告了7例。我们遇到过一例肾上腺脂肪瘤，在计算机断层扫描（CT）上被认为是肾上腺髓质脂肪瘤。一名56岁男性因左腹痛主诉入院。超声检查显示左肾上方有一高回声肿块，CT扫描显示该肿块边界清晰且结构不均匀。肿瘤由包括脂肪组织部分在内的不同密度区域组成。这些发现强烈提示肾上腺髓质脂肪瘤或脂肪肉瘤，遂进行了左肾上腺切除术。肉眼可见，肿瘤由黄色脂肪块和坏死区域组成，周围有薄纤维包膜。肾上腺在肿瘤底部受压。肿瘤重量为290克。显微镜下，肿瘤由与肾上腺皮质细胞直接接触的大脂肪细胞组成，随后被诊断为肾上腺脂肪瘤。术后，患者不再有左腹痛，自手术以来的31个月里未出现复发。
