CAJ | 학술논문

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。
목적：탐토신상선수양지방류적진단、감별진단급외과치료。방법회고성분석2004년10월~2014년8월재아원치료적58례신상선수양지방류환자적림상자료。58례환자술전균행신상선피、수질격소검측급복부초성、CT 검사，14례행 MRI 검사。58례균수술치료병행병리검사，기중51례행후복강경신상선종류절제술，7례행개방신상선종류절제술。결과58례환자신상선피、수질격소무명현이상，CT 검사균제시신상선수양지방류，종류균완정절제，술후병리진단균위신상선수양지방류。다수환자술전유상관증상，술후소실。42례술후획득수방，수방시간위3개월~7년，균미견복발。결론신상선수양지방류적술전진단급감별진단주요의뢰우영상학검사급신상선피、수질격소적검사。대유수술지증적환자，후복강경신상선종류절제술위수선수술방법。
Objective To explore diagnosis,differential diagnosis and surgical treatment of adrenal myeloli-poma. 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 ca-ses were smaller than 5 cm,21 cases were between 5 and 10 cm,4 cases were bigger than 10 cm. The minimum diame-ter was 1. 8 cm with maximum 16 cm. Adrenal cortex hormone test,adrenal medulla hormone test,abdominal ultra-sound 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 di-agnosis 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 examina-tion,adrenal cortex hormone test and adrenal medulla hormone test. Retroperitoneoscopic renal tumor resection is the first choice for patients with operative indications.