【摘要】 目的 探讨肾上腺髓样脂肪瘤的诊断、鉴别诊断及外科治疗。方法 回顾性分析2004年10月~2014年8月在我院治疗的58例肾上腺髓样脂肪瘤患者的临床资料。58例患者术前均行肾上腺皮、髓质激素检测及腹部超声、CT检查,14例行MRI检查。58例均手术治疗并行病理检查,其中51例行后腹腔镜肾上腺肿瘤切除术,7例行开放肾上腺肿瘤切除术。结果 58例患者肾上腺皮、髓质激素无明显异常,CT检查均提示肾上腺髓样脂肪瘤,肿瘤均完整切除,术后病理诊断均为肾上腺髓样脂肪瘤。多数患者术前有相关症状,术后消失。42例术后获得随访,随访时间为3个月~7年,均未见复发。结论 肾上腺髓样脂肪瘤的术前诊断及鉴别诊断主要依赖于影像学检查及肾上腺皮、髓质激素的检查。对有手术指证的患者,后腹腔镜肾上腺肿瘤切除术为首选手术方法。更多还原

【Abstract】 Objective To explore diagnosis,differential diagnosis and surgical treatment of adrenal myelolipoma.Methods 58 patients with adrenal myelolipoma from Oct.2004 to Aug.2014 were analyzed,including 32 males and 26 females,whose ages were between 18 and 74 years old with average age of 34 years.Tumor diameters of 33 cases were smaller than 5 cm,21 cases were between 5 and 10 cm,4 cases were bigger than 10 cm.The minimum diameter was 1.8 cm with maximum 16 cm.Adrenal cortex hormone test,adrenal medulla hormone test,abdominal ultrasound and CT examination were performed in 58 patients.MRI examination was performed in 14 cases.Surgery and postoperative pathological examination were performed in all patients.51 cases underwent retroperitoneoscopic renal tumor resection and 7 cases underwent open surgery.Results There were no significant differences in adrenal cortex hormone and adrenal medulla hormone.58 cases were all adrenal myelolipoma by CT examination and pathological diagnosis after operation.All adrenal myelolipomas were fully resected.Most of the patients had relative symptoms which were disappeared after operation.42 patients were followed up for 3 months to 7 years with no recurrence.Conclusion The preoperative diagnosis and differential diagnosis of adrenal myelolipoma mainly depend on imaging examination,adrenal cortex hormone test and adrenal medulla hormone test.Retroperitoneoscopic renal tumor resection is the first choice for patients with operative indications.更多还原