肾上腺髓质脂肪瘤的诊断和治疗(附12例报告)

目的提高肾上腺髓质脂肪瘤的诊断和治疗水平。方法回顾性分析12例肾上腺髓质脂肪瘤患者的临床资料并复习有关文献。结果12例均经病理证实为本病。CT扫描为肾上腺区脂肪样低密度类圆形肿块,内见散在点状或索条状较高密度影,增强瘤体内较高密度区轻度强化。术后随访0.5～3年,未见肿瘤复发。2例高血压者术后血压恢复正常。结论肾上腺髓质脂肪瘤患者临床表现和体征无特征性,影像学检查是其诊断的主要手段,开放或腹腔镜下肿瘤切除为主要治疗方法,体积较小、无症状者可保守治疗,密切观察随访。该病一般预后良好。

Diagnosis and treatment of adrenal myelolipoma (Report of 12 cases)

Objective] To improve the diagnostic and therapeutic level of adrenal myelolipoma. Methods] 12 cases proved by pathology were respectively analyzed and the relevant literature were reviewed.Results] Postoperative pathology confirmed the diagnosis of adrenal myelolipoma in all 12 cases. Definition of adrenal myelolipoma by CT was based on a well circumscribed nonhomogeneous mass with low density mature fat interspersed with more dense myeloid tissue. Those lesion had mild enhancement. They were followed up for 6 months to 36 months and no recurrent rumors were found. Blood pressure returned to normal after surgery on 2 cases who had hypertension. Conclusions] Diagnosis of adrenal myelolipoma can be mostly established by CT and MRI. The treatment is mainly dependent on open surgery or laparoscopic operation. The small asymptomatic adrenal myelolipoma can be treated conservatively, but a regular follow up is necessary. The prognosis is well.