Abstract:
With only 15 reported cases, anastomosing haemangioma of adrenal is a rare entity and usually presents as adrenal incidentaloma. A hypertensive, diabetic, non-smoker man in his late 60s presented with irritative voiding symptoms. On evaluation, he was found to have a urinary bladder mass and left adrenal incidentaloma measuring 8 cm. Metabolic evaluation confirmed it to be non-functional.The patient underwent transurethral resection of bladder tumour with left laparoscopic adrenalectomy. Intraoperatively, the adrenal tumour was highly vascular with multiple feeder vessels. Grossly it was soft, encapsulated with focal grey-brown areas. Microscopically, most of adrenal gland was replaced by anastomosing proliferating capillary vessels within framework of non-endothelial supporting cells reminiscent of splenic sinusoids. The tumour was positive for CD-31, CD-34, Glut-1 and SMA.Anastomosing haemangioma is a benign entity but it must be differentiated from angiosarcoma. Characteristic imaging features are not yet defined and is, therefore, difficult to diagnose preoperatively.
摘要:
只有15例报告病例,肾上腺吻合性血管瘤是一种罕见的实体,通常表现为肾上腺偶发瘤。高血压,糖尿病,60多岁的非吸烟者出现刺激性排尿症状。关于评估,他被发现有膀胱肿块和左肾上腺偶发瘤,大小为8厘米。代谢评估证实它是无功能的。患者接受了经尿道膀胱肿瘤电切术和左腹腔镜肾上腺切除术。术中,肾上腺肿瘤高度血管化,有多个饲养血管。它非常柔软,封装有焦灰棕色区域。微观上,在非内皮支持细胞的框架内,大部分肾上腺被吻合的增生毛细血管所取代,这让人联想到脾血窦。肿瘤对CD-31、CD-34、Glut-1和SMA呈阳性。吻合血管瘤是一种良性实体,但必须与血管肉瘤区分开。特征成像特征尚未定义,因此,术前难以诊断。