肾上腺血管瘤1例报告并文献复习

Adrenal Hemangioma:a Case Report and Literature Review

目的提高肾上腺血管瘤的诊治水平,增强对肾上腺血管瘤的认识.方法回顾性分析2019年收治的1例左侧肾上腺血管瘤患者的病例资料,归纳总结其临床特征、影像学特征、检验数据、病理报告等,并结合文献综合分析.结果患者体检发现左肾上腺区类圆形囊实性肿块,未见明显临床症状与异常体征,内分泌、生化等检验指标均处于正常范围内.CT表现为弥漫性钙化,边缘强化,强化密度不均匀.术前初步判断无功能腺瘤可能性大,在全身麻醉下行后腹膜入路左侧肾上腺肿物切除术,切除肿瘤大小为38mm×36mm,有完整包膜,病理报告提示肾上腺血管瘤.结论肾上腺血管瘤在临床上罕见,影像学特征多样,与皮质腺瘤、嗜铬细胞瘤、皮质腺癌、节神经细胞瘤等有多种共同表现,术前误诊率高,增强此类罕见疾病的见识有利于提高临床诊断能力.

Objective To improve the diagnosis and treatment of adrenal hemangioma,and to enhance our understanding of adrenal hemangioma.Methods Data of a patient with left adrenal hemangioma admitted to our hospital in 2019 were analyzed retrospectively.The clinical characteristics,imaging features,test data and pathological reports were summarized and the relevant literature was reviewed.Results Physical examination revealed a cystic solid mass in the left adrenal gland.No obvious clinical symptoms and abnormal signs were found,and the endocrine and biochemical indicators were within the normal range.CT showed diffuse calcification,marginal enhancement and uneven intensification.The possibility of non-functioning adenoma was preliminarily determined before operation.After the general anesthesia,the left adrenal mass was resected by the peritoneal approach.The size of the tumor with complete capsule was 38 mm×36 mm.Pathological report suggested adrenal hemangioma.Conclusion Adrenal hemangioma is rare in clinical practice and has various imaging features.It has many common manifestations with cortical adenoma,pheochromocytoma,cortical adenocarcinoma and ganglioneuroma,and is therefore associated with a high preoperative misdiagnosis rate.Enhancing the knowledge of such diseases is conducive to improving clinical diagnostic capabilities.