PDF(Pubmed)
Abstract：
BACKGROUND Hemangiomas of the adrenal gland are rare benign non-functional tumors arising from the gland\'s vascular endothelium. Adrenal hemangiomas are rare in clinical settings, often discovered incidentally during an unrelated diagnostic investigation. CASE REPORT A 39-year-old man presented with a heterogeneous, enhancing 4.56×4.24×3.9-cm mass originating from the right adrenal gland\'s lateral limb, discovered incidentally on computed tomography (CT) to investigate renal colic. He was routinely followed up for 2 years with serial CT scans; the mass exhibited considerable growth compared with baseline, with a relatively stable appearance with hyperdense soft tissue component, fat, and foci of calcification. Dexamethasone suppression test demonstrated suppressed cortisol response, indicating a non-functional mass. Therefore, laparoscopic right adrenalectomy was performed, owing to the benign nature of the preoperative diagnosis of myelolipoma and mass size. The patient experienced an uneventful recovery, with no perioperative complications. The resected mass was 5×4×4 cm in size and weighed 30 g. Histopathology confirmed adrenal hemangioma. Serial sectioning revealed an encapsulated lesion with heterogeneous solid and cystic surfaces. Light microscopy examination showed dilated and congested vascular channels lined by flattened endothelium. Focal mature adipose tissue was seen. CONCLUSIONS The infrequent occurrence of adrenal hemangiomas and their nonspecific clinical and radiological presentation results in a considerable diagnostic challenge and, often, misdiagnosis. Surgical resection is usually necessary to exclude malignant disease, alleviate pressure-related symptoms, and decrease risk of retroperitoneum hemorrhage. These lesions are associated with a good prognosis. One limitation of this report is the lack of preoperative adrenal magnetic resonance imaging of the incidental adrenal mass.
摘要：
背景技术肾上腺血管瘤是由腺体的血管内皮引起的罕见良性非功能性肿瘤。肾上腺血管瘤在临床上很少见，经常在不相关的诊断调查中偶然发现。案例报告一名39岁的男子，增强4.56×4.24×3.9厘米的肿块，起源于右肾上腺的侧肢，在计算机断层扫描（CT）上偶然发现以研究肾绞痛。他被常规随访2年，连续CT扫描；与基线相比，肿块表现出相当大的增长，具有相对稳定的外观，具有高密度的软组织成分，脂肪，和钙化灶。地塞米松抑制试验显示抑制皮质醇反应，表示非功能性质量。因此,进行了腹腔镜右肾上腺切除术,由于骨髓脂肪瘤的术前诊断和肿块大小的良性性质。病人恢复顺利，无围手术期并发症。切除肿块大小5×4×4cm，重30g。组织病理学证实肾上腺血管瘤。连续切片显示具有异质固体和囊性表面的包裹性病变。光学显微镜检查显示扩张和充血的血管通道被扁平的内皮衬里。可见局灶性成熟脂肪组织。结论肾上腺血管瘤的罕见发生及其非特异性临床和放射学表现导致相当大的诊断挑战，经常,误诊。手术切除通常是必要的，以排除恶性疾病。缓解压力相关症状，并降低腹膜后出血的风险。这些病变与良好的预后相关。本报告的局限性之一是缺乏对偶然肾上腺肿块的术前肾上腺磁共振成像。
