肾上腺肿物误诊为肾上腺皮质腺瘤七例分析  

Analysis of Seven Cases of Adrenal Masses Misdiagnosed as Adrenal Cortical Adenoma

作　　者：王晓雁[1] 车宣言 严璞[1] WANG Xiaoyan;CHEN Xuanyan;YAN Pu(Department of Urology,Beijing Tiantan Hospital Affiliated to Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院泌尿外科,北京100070

出　　处：《临床误诊误治》2023年第5期27-31,共5页Clinical Misdiagnosis & Mistherapy

基　　金：北京市医院管理中心“登峰”人才培养计划项目(DFL20190502)。

摘　　要：目的探讨肾上腺肿物误诊为肾上腺皮质腺瘤的原因及防范措施。方法回顾分析2019—2022年误诊为肾上腺皮质腺瘤7例肾上腺肿物的临床资料。结果7例均为偶然检查时发现肾上腺肿物,男2例、女5例,年龄34~66岁,左侧4例、右侧3例,完善肾上腺激素及腹部CT检查后均被误诊为肾上腺皮质腺瘤,行腹腔镜下肿物切除治疗,术后病理确诊为肾上腺节细胞神经瘤3例、嗜铬细胞瘤2例、肾上腺神经鞘瘤1例、脾切除术后代偿性增大副脾1例。7例术后转归良好。结论当肾上腺肿物患者临床及影像学表现不典型时,易被误诊为肾上腺皮质腺瘤;完善的术前检查及充足的术前准备对避免肾上腺肿物的误诊误治具有重要意义。Objective To investigate the causes of misdiagnosis and preventive measures of adrenal masses as adrenal cortical adenoma(ACA).Methods The clinical data of 7 patients with adrenal masses misdiagnosed as ACA from 2019 to 2022 were retrospectively analyzed.Results All 7 cases of adrenal masses were found accidentally by examination,including 2 males and 5 females aged from 34 to 66 years,4 on the left and 3 on the right.After complete adrenal hormone and abdominal CT examination,they were misdiagnosed as ACA,and underwent laparoscopic tumor resection.Postoperative pathological reports included 3 cases of adrenal ganglioneuroma,2 cases of pheochromocytoma,1 case of adrenal schwannoma,and 1 case of compensatory enlargement of the accessory spleen after splenectomy.The prognosis was good in 7 cases after surgery.Con⁃clusion When the clinical and imaging manifestations of patients with adrenal masses are atypical,they are easily misdiagnosed as ACA.Perfect preoperative examination and adequate preoperative preparation are of importance to avoid misdiagnosis and mistreatment of adrenal masses.

关 键 词：肾上腺肿瘤 嗜铬细胞瘤 肾上腺节细胞神经瘤 肾上腺神经鞘瘤 副脾 误诊 肾上腺皮质腺瘤 鉴别诊断 

分 类 号：R736.6[医药卫生—肿瘤]