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偶然发现的上腺质量与轻度自主皮质醇分泌和花红细胞瘤
Padala Ravi Kumar1, Sai Madhav Reddy Duggempudi1, Deepak K Dash1
1Department of Endocrinology, Maharaja Krushna Chandra Gajapati Medical College and Hospital, Berhampur, IND.
Cureus
|March 13, 2026
概括
偶然发现了一种罕见的上腺皮层腺瘤和染细胞瘤的碰撞瘤. 在这个复杂的上腺瘤病例中,全面的评估和仔细的术后管理对于成功的手术结果至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 手术病理学手术病理学
背景情况:
- 上腺偶发性瘤是不相关疾病的成像过程中偶然发现的上腺质量.
- 染细胞瘤和上腺皮层腺瘤与自主皮质醇分泌 (ACS) 的同时存在是罕见的,这给诊断和治疗带来了挑战.
- 轻微的自主皮质醇分泌 (MACS) 和多余的甲醇胺可以微妙地呈现,使诊断复杂化.
研究的目的:
- 报告一种罕见的碰撞瘤病例,其中包括上腺皮层腺瘤和具有自主皮质醇分泌的染细胞瘤.
- 要突出与这种罕见的上腺偶发性瘤相关的诊断和管理复杂性.
- 强调对上腺意外瘤进行彻底的生化和成像评估的重要性.
主要方法:
- 在CT成像中检测到偶然的上腺质量.
- 生物化学评价包括夜间德克萨米他抑制试验 (ONDST),低剂量德克萨米他抑制试验 (LDDST),ACTH水平,24小时尿液分成型甲和诺米他.
- 使用α和β阻塞进行术前管理.
- 开放的左上腺切除术.
- 术后监测和组织病理学分析.
主要成果:
- 上腺质量与成像特征最初暗示良性腺瘤.
- 生物化学测试证实了轻度自主皮质醇分泌 (MACS) 和多余的甲基荷兰胺 (高甲胺).
- 组织病理学揭示了一种上腺皮层腺瘤和染细胞瘤的碰撞瘤.
- 术后降低抗高血压药物需求,并使尿中诺米甲氨酸水平正常化.
结论:
- 对上腺意外瘤,特别是具有双分泌潜力的上腺意外瘤,进行全面的生化和成像评估至关重要.
- 精心的外科手术管理对于减轻碰撞瘤患者的并发症至关重要.
- 识别像这种碰撞瘤这样的罕见上腺瘤对于优化患者的治疗结果至关重要.
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