肾上腺髓样脂肪瘤6例报告及文献复习

目的：探讨肾上腺髓样脂肪瘤的诊断、治疗。方法：收治6例肾上腺髓样脂肪瘤的患者。4例行B超和MRI检查，3例行CT检查。3例行肾素-血管紧张素-醛固酮和皮质醇的测定；2例行儿茶酚胺的测定。6例患者全部接受手术治疗，其中腹腔镜手术切除4例，开放手术2例。结果：6例手术均获得成功。术后病理均诊断为肾上腺髓样脂肪瘤。术前具有的相关症状，术后均消失。5例术后获得随访时间为3个月～3年，均未见复发。结论：肾上腺髓样脂肪瘤术前诊断主要依赖于影像学检查；在治疗上有症状者宜手术切除，无症状且肿瘤直径大于4cm者可考虑手术，手术方式以腹腔镜手术为首选。

Adrenal Myelolipoma:Report of 6 Cases and Review of the Literature

Objective：To explore the diagnosis, treatment and follow-up of adrenal myelolipoma. Methods：6 patients with adrenal myelolipoma were admitted. 4 patients had the B-ultrasound and MRI scan. 3 patients had the CT scan. The renin-angiotensin-aldosterone-cortisol was tested in 3 patients, and the catecholamine was tested in 2 patients. All the patients accepted the operation, 4 were treated by laparoscopic technique, and the other 2 were treated by open surgery. Results： All the operations are successful and the post-operation pathology assures the diagnosis. Symptoms disappeared after operation. 5 patients were followed-up for 3 months-3 years. No recurrence was found. Conclusions： Before operation the clinical diagnosis of the adrenal myelolipoma depends mainly on the imaging tests; The asymptomatic myelolipomas with symptoms are advised to have surgery to remove; Surgery is reserved for symptomatic lesions or possibly larger tumors （〉 4 cm）, the laparoscopic technique is the first choice.