肾上腺皮质嗜酸细胞肿瘤的影像学表现及预后

Imaging features and postoperative follow-up of adrenocortical oncocytic adenocarcinoma

目的探讨肾上腺皮质嗜酸细胞肿瘤(adrenocortical oncocytic neoplasm,AOA)的影像学表现及预后。方法回顾性分析10例经病理证实的肾上腺皮质嗜酸细胞肿瘤的影像学表现,术后对患者进行随访。结果 10例患者影像学表现:CT平扫表现为稍低密度肿块,MRI表现为稍长T1、T2信号;增强后CT及MRI表现为动脉期呈不均匀轻度强化,静脉期及延迟期呈持续性强化。10例患者术后随访,9例未见复发及转移,1例术后半年肿瘤复发,随后转移。结论肾上腺皮质嗜酸细胞肿瘤没有显著的临床和影像学特征,术前影像学很难做出定性诊断,易误诊为嗜铬细胞瘤等其他肿瘤,对于较大的肾上腺无功能腺瘤,应考虑到嗜酸细胞肿瘤的可能性;基于肾上腺嗜酸细胞肿瘤部分尚有交界性和恶性,因此仍需术后密切随访。

Objective To investigate the imaging features and postoperative follow-up of adrenocortical oncocytic adenocarcinoma. Methods The imaging features of 10 cases with adrenocortical oncocytic adenocarcinoma confirmed by pathological analysis were retrospectively analyzed with postoperative follow-up. Results CT scan in 10 patients： CT displayed isointense or slightly hypodense mass. The signals were slight hyperintensity on both T1- and T2-weighted images, and in the arterial phase, the images of enhanced CT and enhanced MRI showed mild heterogeneous enhancement, and continuously enhanced in venous and delay phase. In the postoperative follow-up of 10 patients after CT contrast enhanced scan, relapse and metastasis weren’t seen in 9 cases, 1 case was found relapse a half year after operation and metastasis followed. Conclusion The adrenocortical oncocytic adenocarcinoma has little clinical or imaging characteristics. It is difficult to make a differential diagnosis by imaging before operation, and may be misdiagnosed as pheochromocytoma or other tumours. To large nonfunctioning adrenal tumor, the possibility of oncocytic adenocarcinoma should be considered. As the adrenocortical oncocytic adenocarcinoma has its borderline and malignant, the postoperative follow-up is significant.