Tay S K, Chen H W, Chu S H
Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Changgeng Yi Xue Za Zhi. 1998 Jun;21(2):195-9.
Adrenal hemangiomas are rare, nonfunctioning benign tumors. They are well circumscribed and comprise of closely adjacent vascular channels of varying sizes that are lined with a single layer of endothelium. When they occur, they are frequently located in the skin and liver. There are no characteristic symptoms of adrenal hemangioma unless the tumor reaches a size large enough to exert pressure. To our knowledge, there have been 14 clinical cases of adrenal hemangiomas reported, all with similar pathologic features. We present 2 additional cases, which were identified incidentally after non-urologic complaints (epigastric fullness and low back pain in patient 1 and patient 2, respectively). In these 2 patients, the tumors were surgically removed and diagnosed postoperatively as adrenal hemangiomas. Preoperative radiologic findings on plain film and abdominal computerized tomography showed the characteristic round calcifications with translucent centers, typical of phleboliths, to be pathognomonic of adrenal gland hemangiomas. Unfortunately, this characteristic feature of adrenal hemangioma existed in only one case report. In conclusion, the preoperative diagnosis of adrenal hemangioma is difficult but should be kept in mind as being part of the differential diagnosis of adrenal tumors.
肾上腺血管瘤是罕见的、无功能的良性肿瘤。它们边界清晰,由大小各异、紧密相邻的血管通道组成,内衬单层内皮细胞。肾上腺血管瘤发生时,常位于皮肤和肝脏。肾上腺血管瘤没有特征性症状,除非肿瘤长得足够大到产生压迫。据我们所知,已报道了14例肾上腺血管瘤临床病例,所有病例都有相似的病理特征。我们现报告另外2例,这2例是在非泌尿系统主诉(分别为患者1的上腹部饱胀和患者2的下背部疼痛)后偶然发现的。在这2例患者中,肿瘤均通过手术切除,术后诊断为肾上腺血管瘤。术前平片和腹部计算机断层扫描的影像学表现显示,具有典型的中央透亮的圆形钙化,即静脉石,这是肾上腺血管瘤的特征性表现。遗憾的是,肾上腺血管瘤的这一特征仅在一篇病例报告中出现。总之,肾上腺血管瘤的术前诊断困难,但在肾上腺肿瘤的鉴别诊断中应予以考虑。