南方医科大学学报 ›› 2013, Vol. 33 ›› Issue (01): 159-.

• • 上一篇    

左肾上腺囊性成熟性畸胎瘤1例报告

黄东方,王云炎   

  • 出版日期:2013-01-20 发布日期:2013-01-20

Left cystic mature adrenal teratoma: a case report

  • Online:2013-01-20 Published:2013-01-20

摘要: :目的探讨肾上腺畸胎瘤的诊断、鉴别诊断、临床表现及治疗方法。方法分析1例老年女性合并糖尿病患者,体检时B超
发现左肾多发囊性占位,腹部CT平扫及增强检查显示左侧肾上腺区混杂密度肿块影,直径约9.0 cm,密度欠均匀,遂待血糖水
平控制尚可后行手术切除,术后病理报告可见肿物呈多房性,囊内有少量油脂样,囊壁厚0.2~0.4 cm,切面见骨骼,表面有脂肪组
织,考虑为囊性成熟性畸胎瘤。临床表现及治疗方法通过查询国内外文献获得。结果最终诊断为左侧囊性成熟性畸胎瘤,手
术切除后随访半年,效果良好,未见局部复发及转移。结论肾上腺成熟畸胎瘤是较为罕见的一种生殖细胞来源肿瘤,有恶变风
险,可通过B超及CT检查特点初步诊断,应注意与其它肾上腺源性肿瘤的鉴别,及早诊断及手术切除是治疗关键,不能手术切
除或潜在恶性者则行联合化疗,病理检查确定诊断,需要终身随访。

Abstract: Objective Adrenal teratoma is a rare germline tumor with a malignant potential. We present a case of left adrenal
teratoma complicated by diabetes. The 64-year-old female patient showed multiple cystic space-occupying masses in the left
kidney in B-mode ultrasound examination, and plain and enhanced CT reported a 9.0 cm heterogeneous mass in the left
adrenal gland. After effective control of blood glucose, the mass was surgically removed and sent for pathological
examination. The mass consisted of multiple cysts containing lipid-like substance with a cyst wall thickness of 0.2-0.4 cm; bony
structures were found on the sections of the mass with fat tissues on the mass surface. A final diagnosis of left cystic mature
adrenal tetrama was made based on the clinical and pathological findings and literature review. The patient was followed up
for 6 months and no local recurrence or metastasis was found. Mature adrenal teratoma can be easily diagnosed by ultrasound
and CT examinations and should be distinguished from other tumors of an adrenal source. Early diagnosis and early surgical
resection is key to the treatment, and a definite diagnosis can be made pathologically. Chemotherapy is necessary in inoperable
cases or for such tumors with a malignant potential. The patients should be followed up for life time after the treatment.