肾上腺囊肿的诊断与治疗(附15例报告)

Diagnosis and treatment of adrenal cyst (Report of 15 cases)

目的:探讨肾上腺囊肿的诊断与治疗方法。方法:回顾性分析15例肾上腺囊肿的临床资料。结果:B超检查12例,9例显示肾上腺区为无回声液性囊性暗区, 3 例提示为低回声包块。14 例行CT检查为低密度肿块,其中7例提示囊壁有钙化影。MRI检查1例为包膜完整的占位病变。15 例均行手术治疗,其中行囊肿及同侧肾上腺切除6例,囊肿及肾上腺部分切除术7例,单纯囊肿切除术2例。9例行开放手术,6例经后腹腔镜手术。假性囊肿7例,内皮性5例,上皮性1例,2例未标明囊肿类型。结论:肾上腺囊肿临床上无特征性症状与体征,内分泌功能检查多数正常。B超与CT在诊断中占有重要的地位。注意与肝、胰、肾及脾囊肿,以及肾上腺肿瘤相鉴别。除直径<3 cm、内分泌功能正常、无症状、CT提示单纯性肾上腺囊肿外,均应采取积极手术治疗。建议囊肿切除加同侧肾上腺切除。后腹腔镜手术相对开放手术更有优越性。

Objective:To present our experience of diagnosis and treatment of adrenal cyst. Methods:15 cases of adrenal cysts were reviewed and analyzed. Results:All adrenal cysts in this group were excised.Of 15 specimens, 7 pseudocysts, 5 endothelialcysts, 1 waseepithelialcyst. Conclusions: symptoms and endocrine abnormalities are rare in adrenal cyst. CT scan and B ultrasound are most important in diagnosis. Surgical excision, is indicated in presence of symptoms, endocrine abnormalities (even when subclinic),complications, suspicion of malignancy and/or large size (>3 cm). Adrenal gland must be excised en bloc, also because of the possible presence of other adrenal lesions. Laparoscopic adrenal cyst resection, especially by laparoscopic approach,is much more of advantage than open surgical operation.