北京大学学报(医学版) ›› 2021, Vol. 53 ›› Issue (4): 808-810. doi: 10.19723/j.issn.1671-167X.2021.04.032

• 病例报告 • 上一篇    下一篇

肾上腺海绵状血管瘤1例及文献回顾

康文玉1,王璐2,邱敏2,Δ(),张帆2,郭巍1,Δ(),强亚勇1,拓鹏飞1,宗有龙1,刘磊磊1,王帅帅1   

  1. 1.延安市中医医院,陕西延安 716000
    2.北京大学第三医院泌尿外科,北京 100191
  • 收稿日期:2021-03-16 出版日期:2021-08-18 发布日期:2021-08-25
  • 通讯作者: 邱敏,郭巍 E-mail:qiumin@bjmu.edu.cn;15756560@qq.com

Adrenal cavernous hemangioma: A case report and literature review

KANG Wen-yu1,WANG Lu2,QIU Min2,Δ(),ZHANG Fan2,GUO Wei1,Δ(),QIANG Ya-yong1,TUO Peng-fei1,ZONG You-long1,LIU Lei-lei1,WANG Shuai-shuai1   

  1. 1. Department of Urology, Yan’an City Hospital of Traditional Chinese Medicine, Yan’an 716000, Shaanxi, China
    2. Department of Urology, Peking University Third Hospital, Beijing 100191, China
  • Received:2021-03-16 Online:2021-08-18 Published:2021-08-25
  • Contact: Min QIU,Wei GUO E-mail:qiumin@bjmu.edu.cn;15756560@qq.com

关键词: 肾上腺肿瘤, 海绵状血管瘤, 肾上腺切除术

Abstract:

A 57-year-old male patient was referred to our department with complaints of his right adrenal gland occupancy and hypertension about 6 months. When admitted to the hospital, the blood pressure was about 160/100 mmHg, and the heart rate was 110 beats/min. He was no obvious obesity, acne, abnormal mood, without weakness of limbs, acral numbness, palpitation and headache. He presented with type 2 diabetes for more than 3 years, with oral administration of metformin enteric coated tablets and subcutaneous injection of insulin glargine to control blood glucose, and satisfied with blood glucose control. Enhanced CT showed that: the right adrenal gland showed a kind of oval isodense, slightly hypodense shadow, the edge was clear, lobular change, the size was about 5.8 cm×5.4 cm, uneven density, there were nodular and strip calcification, round lipid containing area and strip low density area, and the CT value of solid part was about 34 HU. Enhanced scan showed heterogeneous nodular enhancement in the solid part of the right adrenal gland, nodular enhancement could be seen inside. The CT values of solid part in arterial phase, venous phase and delayed phase were 45 HU, 50 HU and 81 HU, respectively. Considering from the right adrenal gland, cortical cancer was more likely. No obvious abnormality was found in his endocrine examination. After adequate preoperative preparation, retroperitoneal laparoscopic adrenalectomy was performed under general anesthesia. During the operation, the 6 cm adrenal tumor was closely related to the inferior vena cava and liver, and after careful separation, the tumor was completely removed and normal adrenal tissue was preserved. The operation lasted 180 min and the blood loss was 100 mL, and the blood pressure was stable during and after the operation. There was no obvious complication. The results of pathological examinations were as follows: the size of the tumor was 7.5 cm×6.0 cm×3.5 cm, soft, with intact capsule and grayish-red cystic in section. Pathological diagnosis: (right adrenal gland) cavernous hemangioma, secondary intravascular thrombosis, old hemorrhagic infarction with calcification and ossification. After 6 months of observation, no obvious complications and tumor recurrence were found. In summary, cavernous hemangioma of adrenal gland is a rare histopathological change. Its essence is a malformed vascular mass. Blood retention is the cause of thrombosis and calcification in malformed vessels. The imaging findings were inhomogeneous enhancement of soft tissue masses, and the adrenal function examination showed no obvious abnormalities. Retroperitoneal laparoscopic surgery is feasible after adequate preoperative preparation. It is difficult to diagnose the disease preoperatively and needs to be confirmed by postoperative pathology.

Key words: Adrenal gland neoplasms, Cavernous hemangioma, Adrenalectomy

中图分类号: 

  • R736.6

图1

肾上腺海绵状血管瘤CT表现"

图2

右侧肾上腺肿物大体标本"

图3

右侧肾上腺肿物组织病理检查(HE ×10)"

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