肾上腺髓质脂肪瘤的诊断与治疗

Diagnosis and treatment of adrenal myelolipoma

目的:提高肾上腺髓质脂肪瘤的诊断和治疗水平。方法:回顾性分析l5例肾上腺髓质脂肪瘤患者的临床资料并复习有关文献。年龄33～65岁,平均49岁。男9例,女6例。右侧10例,左侧5例。腰痛6例,高血压2例。术前诊断肾上腺髓质脂肪瘤14例。病程2个月～3年。结果:15例患者均行手术治疗,经十一肋间切口行开放手术11例,后腹腔镜下切除肿瘤4例。病理均证实为肾上腺髓质脂肪瘤。术后随访6个月～7.5年,均未发现肿瘤复发。2例高血压者术后血压恢复正常。结论:肾上腺髓质脂肪瘤患者临床表现无特征性,B超、CT及MRI等影像学检查是该病术前诊断的主要依据,开放手术或后腹腔镜下单纯切除肿瘤是主要治疗方法,一般预后良好。

Objective To improve the diagnostic and therapeutic level of adrenal myelolipoma. Methods The clinical data from fifteen cases of adrenal myelolipma were retrospectively analyzed, and the relevant literature were reviewed. The mean age of patients was 49 years （range from 33 to 65 years）. Among 15 patients, 9 were males, 6 were females; and 10 cases were in right while 5 were in left. Six patients suffered from lumbodynia and 2 hypertension. Fourteen cases were preoperatively diagnozed as adrenal myelolipma. The course of disease lasted from 2 months to 3 years. Results All cases were surgically treated, including 11 cases of open surgical excision by way of 11 inter ribs, and 4 cases of retroperitoneal laparoscopic excision. Fifteen cases were all confirmed pathologically as adrenal myelolipma. Patients survived after operation and were followed up from six months to seven and a half years. No tumor recurrence was found. The blood pressure of 2 hypertension patients was recovered to normal level. Conclusion The clinical manifestation of adrenal myelolipma patient does not show any property. The major method for preoperative diagnosis is imaging inspection including Bultrasound, CT and MRI. Surgical extirpation and laparoscopic excision are the main methods of treatment. And the prognosis is generally good.