PDF(Pubmed)
Abstract：
Adrenal ganglioneuromas are rare tumors arising from sympathetic ganglion cells that may present similarly to other adrenal tumors, making preoperative diagnosis challenging. We present a case of a young woman with a history of Hashimoto\'s thyroiditis who presented with hypertension and headaches. An abdominal CT scan revealed a large left adrenal mass, and while laboratory tests for catecholamines and metanephrines were normal, the suspicion for pheochromocytoma remained high given the size of the mass and persistent hypertension. The patient was started on alpha-blockers and beta-blockers in preparation for surgical removal. Pathology revealed a mature ganglioneuroma without evidence of malignancy, and postoperative blood pressure was normalized. We hypothesize that vessel compression from the large mass created functional stenosis, resulting in persistent hypertension. This case highlights the importance of a thorough workup for hypertension in young adults and routine preventative care visits to avoid delayed management. Adrenalectomy with histopathological examination remains the gold standard for treatment and diagnosis, and patients have a good prognosis following resection, with minimal need for recurrent therapy.
摘要：
肾上腺节神经瘤是由交感神经节细胞引起的罕见肿瘤，可能与其他肾上腺肿瘤相似。使术前诊断具有挑战性。我们介绍了一例有桥本甲状腺炎病史的年轻女性，并伴有高血压和头痛。腹部CT扫描显示左侧肾上腺肿块较大,虽然儿茶酚胺和间肾上腺素的实验室测试是正常的，考虑到肿块的大小和持续性高血压，嗜铬细胞瘤的怀疑仍然很高。患者开始使用α-受体阻滞剂和β-受体阻滞剂，准备手术切除。病理显示一个成熟的节细胞神经瘤，没有恶性肿瘤的证据，术后血压恢复正常。我们假设大肿块对血管的压迫造成了功能性狭窄，导致持续性高血压。此案例强调了对年轻人进行彻底检查高血压和常规预防性护理访问以避免延迟管理的重要性。肾上腺切除术和组织病理学检查仍然是治疗和诊断的金标准，切除后患者预后良好，很少需要反复治疗。
