伴发内分泌功能紊乱肾上腺髓样脂肪瘤的诊断及其治疗  被引量:7

Treatment and diagnosis of adrenal myelolipoma accompanied by endocrine disorder

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作  者:宿恒川[1] 黄欣[1] 戴军[1] 周文龙[1] 黄宝星[1] 曹万里[1] 成康[1] 孙福康[1] 

机构地区:[1]上海交通大学医学院附属瑞金医院泌尿外科,上海200025

出  处:《临床泌尿外科杂志》2015年第2期130-132,共3页Journal of Clinical Urology

基  金:上海市教育委员会科研创新项目(编号14YZ050)

摘  要:目的:进一步提高伴发内分泌功能紊乱的肾上腺髓样脂肪瘤(AML)的诊断与治疗水平。方法:收集2005年~2013年我院收治并确诊的伴有内分泌功能紊乱的3例AML患者,包括高醛固酮血症、高皮质醇血症以及高雄激素血症患者各1例,对该3例患者的临床资料进行对比分析。结果:3例患者表现出同内分泌功能紊乱相对应的典型临床症状、体征改变,影像学特点均表现为卵圆形高低密度混合肿块,病理表现为肿块由造血细胞以及脂肪细胞组成,伴随肾上腺皮质功能带的增生或瘤变。治疗上,1例采用单侧肿瘤切除加患侧肾上腺部分切除术,2例采用患侧肾上腺全部切除术。术后随访期间,患者原有症状消失,内分泌功能恢复正常,所有患者未见复发。结论:伴发内分泌功能紊乱的AML是AML的一种特殊类型,内分泌功能紊乱类型往往对应肾上腺皮质功能带的相应改变,诊断AML是否伴发内分泌功能需要结合患者临床症状、生化检查、内分泌功能、影像学检查以及病理结果。一旦发现伴发内分泌功能紊乱,即应手术治疗。Objective:To improve the level of diagnosis and treatment for adrenal myelolipoma accompanied by endocrine disorder.Method:The clinical data of three cases who presented with adrenal myelolipoma accompanied by endocrine disorder from 2005 to 2013were analyzed,including one case of hyperaldosteronemia,one case of hypercortisolism and one case of hyperandrogenism.Result:These patients had obvious clinical syndromes associated with endocrine disorder.The image features revealed an oval tumor consisting of mixed mass with positive and negative attenuation values.The postoperative pathology reports showed the tumors comprised mature adipose cells and scattered islands of hematopoietic cells companied by hyperplasia or neoplasia of adrenal functional areas.One patient of adrenal myelolipoma adopted unilateral adrenal tumor resection plus ipsilateral partial adrenalectomy and two adopted ipsilateral adrenalectomy.During the period of follow-up,the previous clinical symptoms of these patients disappeared and biochemical examinations were normal.No recurrence could be seen.Conclusion:Adrenal myelolipoma accompanied by endocrine disorder is a special type of adrenal myelolipoma,which is associated with the pathological change of adrenal cortex and the diagnosis of this disease depends on clinical symptoms,endocrine and biochemical examination,imaging examination and pathological results.Once it is diagnosed,surgical treatment should be required.

关 键 词:肾上腺髓样脂肪瘤 内分泌功能紊乱 诊断 治疗 

分 类 号:R736.6[医药卫生—肿瘤]

 

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