肾上腺髓脂瘤的诊断与治疗(附18例报告)  

Diagnosis and treatment of adrenal myelolipoma (Report of 18 cases)

作　　者：万江华[1] 靳凤烁[1] 江军[1] 李黔生[1] 李彦锋[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所泌尿外科,重庆400042

出　　处：《中国现代医学杂志》2004年第19期111-112,115,共3页China Journal of Modern Medicine

摘　　要：目的提高肾上腺髓脂瘤的诊治水平。方法回顾性分析18例肾上腺髓脂瘤的临床资料。10例有腰背部疼痛症状,3例出现腹部包块。除2例肾上腺髓脂瘤破裂出血者误诊为肾错构瘤外,其余16例经CT或MRI确诊。结果14例行肾上腺肿瘤切除术,其中3例行后腹腔镜手术,术后均病理证实为肾上腺髓脂瘤。4例未手术。结论肾上腺髓脂瘤诊断需靠CT或MRI检查。所有病例均应行肾上腺内分泌功能检测。对直径小于4 cm的无功能肿瘤可随访观察,对直径大于4 cm的肿瘤均应手术切除。后腹腔镜手术是一种较好的选择,但对巨大髓脂瘤或髓脂瘤急性出血仍应行开放手术。Objective: To improve the diagnosis and treatment of adrenal myelolipoma. Methods: The clinical data of 18 cases were analyzed retrospectively. Of the 18 patients, 10 presented with abdominal or flank pain, 3 with abdominal mass. 16 cases were diagnosed only by CT or MRI, but 2 cases with acute hemorrhage were misdiagnosed as renal leiomyolipoma. Results: 14 humors were removed by operations and proved by pathologists, including 3 tumors resected by posterior laparoscopic approach. 4 patients were treated conservatively. Conclusions: The diagnosis can be established on CT or MRI alone. Hormonal screening should be performed in all cases. The non-functioning tumors smaller than 4 cm in size could be followed up, while the ones larger than 4 cm in size should be removed. Posterior laparoscopic adrenalectomy is a better choice for operations, but giant tumors or tumors with acute hemorrhage should be resected by open surgery.

关 键 词：肾上腺髓脂瘤 影像诊断 手术治疗 

分 类 号：R736.6[医药卫生—肿瘤]