肾上腺成熟畸胎瘤的临床特征及治疗

目的探讨肾上腺成熟畸胎瘤的临床特征及治疗方法。方法回顾性分析6例经手术切除肿瘤、术后结合病理证实为肾上腺成熟畸胎瘤患者的临床、影像、病理学特点，评价手术治疗效果。结果6例患者中，肿块位于左侧肾上腺2例，右侧4例；患侧腰痛3例，体检发现肾上腺肿物3例。6例患者均无高血压史。CT平扫检查示肿物位于肾上腺区域，为椭圆形或哑铃状的囊、实性混合包块，其直径3～6cm，内有钙化灶，多表现为斑块状或弧形，包块内可见脂肪样密度灶。B型超声示肾上腺区囊实性肿物，边界清晰。CT增强后肿物边缘和内部软组织成分可见强化。病理示镜下可见钙化、软骨、脂肪、鳞状上皮及黏液柱状上皮等。6例患者均行肾上腺肿瘤切除，术中见肿瘤边界清楚，血供不丰富。术后随访1—8年未见肿瘤复发。结论成熟畸胎瘤发生于肾上腺罕见，以女性多见，多发于年轻人，临床症状不典型，对其术前诊断主要依靠影像学检查。肾上腺成熟畸胎瘤宜行手术切除，预后良好。

Clinical features and management of adrenal mature teratoma

Objective To review the clinical features and management of adrenal mature teratoma. Methods The clinical symptoms,histopatbology,CT findings and surgical outcomes of 6 patients with adrenal mature teratoma were retrospectively reviewed. Results Among 6 patents, the lesions were located on the left adrenal gland in 2 cases and on the right side in 4. Three patients had symptoms of ipsilateral low back pain and lesions were discovered by health check-up in 3 asymptomatic patients. No patients had history of hypertension. CT scan revealed the oval or dumbbell shaped mass in adrenal region,with mixed cystic and solid components. The mass was between 3 -6 cm in diameters with patch or arc shaped calcification, and also with visible fat density range. Ultrasonography presented mixed cystic and solid mass in adrenal region with clear boundary. Enhanced CT showed that the edge of mass and soft tissue was enhanced. In microscopic examination,the mass was composed of calcification, cartilage, fat, squamous epithelia and mucous colunmar epithelia. All 6 patients underwent adrcnalectomy for adrenal tumors, the surgical specimens showed that the boundary of mass was well defined and there was lack of blood supply. The patients were followed-up for 1 - 8 y, and no recurrence was found. Conclusion Adrenal mature teratoma is a rare congenital tumor, it is more common in women and young people. Clinical symptoms are atypical. Its preoperative diagnosis depends on imaging studies. Complete surgical resection is the best way for treatment of adrenal mature teratoma and the prognosis is good.