肾上腺囊性畸胎瘤1例报告并文献复习

Adrenal Teratoma:a case report and literature review

目的探讨肾上腺畸胎瘤的临床表现和治疗方法。方法回顾性分析平15例素健康44岁女性,体检时发现巨大腹部肿物,腹部超声波及增强CT检查显示右侧肾上腺密度不均巨大囊性肿物(大小8.5cm×8.2cm×7 cm),其间可见条索状钙化,边界清晰。遂行手术切除,术后病理报告可见复层鳞状上皮及皮肤附属器(皮脂腺及毛囊)、呼吸上皮、脂肪组织、结缔组织以及散在神经纤维,诊断为右肾上腺巨大良性成熟畸胎瘤。结果手术切除后随访1年未见复发或转移。文献复习国内、外目前相似病例共报告21例,大多发生在女性,肿物以右侧居多,患者多无自觉症状。肾上腺畸胎瘤可通过超声和CT检查初步诊断,发现后应尽早手术,术后依靠病理确诊,术后近期随访效果良好。结论畸胎瘤是较为罕见生殖细胞来源肿瘤,睾丸以外器官如肾上腺畸胎瘤罕见,有恶变风险,可以通过超声波和CT检查特点初步诊断,及早手术切除治疗,病理检查确定诊断,需要定期随访。

Objective To discuss the clinical manifestation and treatment of adrenal teratoma. Methods One case of adrenal teratoma was retrospectively analyzed, clinical record including ultrasound and CT examination reports and results of pathologic diagnisis after operation. Cnilicl manifestation and treatment of adrenal teratoma was analyzed under review of literature. Results In this case, the is a big abdominal mass was found in a female patient without any unwell during a general health examination. The examination of Ultrasound and CT scans revealed a mass with welldefined margin and calcifications at the right adrenal gland （size was 8.5cm × 8.2cm × 7 cm）. After the operation, the histological examination of the mass showed skin with its appendages, respiratory epithelium, never fiber, fat and connective tissue. The final diagnosis was mature adrenal teratoma. One year follow-up, the tumor didn＇t recur or metastasize. According to our literature review, only 21 cases have been reported by now. In all of these patients, female is majority and it was more often occurred in the right lesion. Most patients don＇ t have any rational symptom. The teratoma could be diagnosed easily by ultrasonic examination and computed tomography. Early diagnosis and surgical treatment is recommended, and the pathologic examination is necessary. Conclusion The adrenal teratoma is a germ cell tumor. It is easily progressed to malignant, Early diagnosis and early surgical resection is the key point of treatment.