Han M, Burnett A L, Fishman E K, Marshall F F
Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
J Urol. 1997 Apr;157(4):1213-6.
We determined the natural history and clarified the treatment of adrenal myelolipoma.
A retrospective review of medical records and radiographic imaging studies of 20 patients diagnosed with adrenal myelolipoma was performed.
Of 20 patients 4 presented with abdominal pain and 1 had Cushing's syndrome. The remaining tumors were discovered incidentally. Four patients underwent surgery because of abdominal pain in 2, adrenal hyperfunction (Cushing's syndrome) in 1 and a tumor 10.5 cm. in largest dimension in 1. Of 15 patients (16 adrenal myelolipomas) followed without surgical intervention for an average of 3.2 years (range 0.3 to 10.8) 13 remained asymptomatic and 2 experienced persistent, vague abdominal discomfort. One patient was lost to followup. A total of 13 tumors from 12 patients was serially imaged, with tumor size increasing in 6, decreasing in 2 and remaining unchanged in 5.
These data suggest that the majority of adrenal myelolipomas can be treated conservatively. While tumors can become enlarged, they also exhibit variable growth, and size and growth rate do not necessarily correlate with symptoms. Computerized tomography can be used for diagnosis.
我们确定了肾上腺髓脂肪瘤的自然病史并阐明了其治疗方法。
对20例诊断为肾上腺髓脂肪瘤的患者的病历和影像学研究进行了回顾性分析。
20例患者中，4例出现腹痛，1例患有库欣综合征。其余肿瘤为偶然发现。4例患者因腹痛（2例）、肾上腺功能亢进（库欣综合征，1例）和肿瘤最大直径达10.5 cm（1例）而接受手术。15例患者（16个肾上腺髓脂肪瘤）未接受手术干预，平均随访3.2年（范围0.3至10.8年），其中13例无症状，2例有持续性、模糊的腹部不适。1例患者失访。对12例患者的总共13个肿瘤进行了系列成像，其中6个肿瘤增大，2个减小，5个保持不变。
这些数据表明，大多数肾上腺髓脂肪瘤可以保守治疗。虽然肿瘤可能会增大，但它们也表现出不同的生长情况，大小和生长速度不一定与症状相关。计算机断层扫描可用于诊断。
