肾上腺钙化1例并文献复习

A case of adrenal calcification and review of relevant literature

肾上腺钙化是一种罕见疾病,大多数伴有肾上腺其他疾病,如肾上腺出血、结核、肿瘤、遗传病等。影像学中钙化表现为结石样强回声或高密度钙质沉淀。钙化可发生在人体各种器官和组织中,但肾上腺钙化的检出率相对较低。在此,本文报道1例右侧肾上腺弥漫性钙化的年轻男性患者,本例患者右侧肾上腺弥漫性钙化且伴有垂体激素异常,相关疾病国内外报道不多见。本病例特点是右侧肾上腺较大,形态不规则,其内充满致密结节影,皮质醇节律消失,检测肾上腺其他激素结果未见异常。目前,对于肾上腺钙化是否需要手术治疗还存在争议。在临床实践中,大多数伴有钙化的肾上腺病变病理上是良性的,临床获益与病变的最大直径显著相关。结合该患者钙化灶的大小和临床症状,应采取积极动态随访来评估伴有钙化的肾上腺病变的最佳手术指征。通过对本病例和相关文献的复习,进一步探讨临床获益的最大化,严格控制手术指征,避免不必要的手术干预。

Adrenal calcification is a rare disease,usually associated with other adrenal diseases,such as adrenal hemorrhage,tuberculosis,tumors,and genetic disorders.Calcification appears as highly echogenic stones or high-density calcium deposits on imaging.Calcification may occur in various organs and tissues in the body,but adrenal calcification is rarely detected.This paper herein reports a young male patient with diffuse calcification of the right adrenal gland with pituitary hormone abnormalities,a condition that has not been widely reported at domestic or abroad.This case is characterized by a large,irregularly shaped right adrenal gland filled with dense nodular shadows and a loss of cortisol rhythm,with no abnormalities in other adrenal hormones.The necessity for surgical treatment for adrenal calcification remains controversial.In clinical practice,most adrenal calcifications are pathologically benign,and the clinical benefit is significantly related to the maximum diameter of the lesion.Aggressive dynamic follow-up should be performed to assess the best indication for surgery for adrenal calcification in combination with the size of the calcified foci and clinical symptoms in this patient.A further exploration of the maximization of clinical benefit and strictly controlled surgical indications will be made by reviewing this case and relevant literature,to avoid unnecessary surgical interventions.