13例肾上腺畸胎瘤临床诊疗分析并文献复习

目的探讨肾上腺畸胎瘤(adrenal teratoma,AT)的临床特征及外科诊疗方法,以提高对该病的认识。方法收集2012-10—2019-03间郑州大学第一附属医院收治的13例AT患者的临床及随访资料,对其进行回顾性分析并复习国内外相关文献。结果13例患者中,男1例(7.7%),女12例(92.3%);中位年龄31岁。左侧8例(61.5%),右侧5例(38.5%)。3例(23.1%)因腹部不适或胀痛就诊,10例(76.9%)均为体检时发现。10例行腹腔镜肾上腺切除术,3例行开腹肾上腺切除术,均未发生围手术期并发症,术后病理示肾上腺成熟性畸胎瘤。术后均获5~81个月随访,13例均预后良好,无复发或癌变。结论AT是一种罕见的生殖细胞来源肿瘤,发病年龄跨度大,临床表现缺乏特异性。术前诊断主要依靠影像学检查。完整切除肿瘤是AT治疗的关键,成熟性AT手术切除预后良好;未成熟性AT术后易复发,需辅助放、化疗,且需终身随访。

Analysis of clinical diagnosis and treatment of 13 cases of adrenal teratoma and literature review

Objective To improve the understanding of adrenal teratoma(AT)by exploring the clinical features and surgical diagnosis and the treatment of this disease.Methods From October,2012 to March,2019,the clinical and prognostic data of 13 patients with AT admitted to the First Affiliated Hospital of Zhengzhou University were collected and retrospectively analyzed.And we reviewed domestic and foreign literatures related to AT.Results The median age of 13 patients was 31 years old.There were 1 male(7.7%)and 12 females(92.3%);There were 8 patients(61.5%)with lesions on the left and the other 5 patients with lesions on the right(38.5%);3 cases(23.1%)visited hospital due to abdominal discomfort or pain,the remaining 10 cases(76.9%)were all found by physical examination;10 cases were treated by laparoscopic adrenalectomy,3 cases were treated by open adrenalectomy.None of them had perioperative complications.The pathological diagnoses after the operation were all mature adrenal teratoma.The patients were successfully followed for 5 to 81 months after operation.All 13 cases had a good prognosis without recurrence or canceration.Conclusion AT is a rare germ cell-derived tumor with a large age span and a lack of specificity in clinical manifestations.Its preoperative diagnosis mainly relies on imaging examination.Complete resection of the tumor is the key to the treatment of AT.Surgical resection of mature teratoma has a good prognosis.Immature teratoma is prone to recurrence after surgery and needs adjuvant radiotherapy and chemotherapy as well as life-long prognosis.