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首页> 外文期刊>Case Reports in Urology >Rare Case of Multiple Perirenal, Extra-Adrenal Myelolipoma: Case Report, Current Management Options, and Literature Review
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Rare Case of Multiple Perirenal, Extra-Adrenal Myelolipoma: Case Report, Current Management Options, and Literature Review

机译：罕见的多发性肝癌，肾上腺髓素瘤：案例报告，当前管理方案和文献综述

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Extra-adrenal myelolipomas are rare, asymptomatic entities, although large tumors may cause local symptoms or hemorrhage. When these lesions occur outside the adrenals in the retroperitoneum, they are radiographically easily confused with both primary and secondary retroperitoneal tumors, which tend to be aggressive. Although myelolipomas are benign and can be managed conservatively, if malignancy is suspected, a surgical procedure is an option. We report a case of a 68-year-old patient with multiple perirenal extra-adrenal myelolipomas. Initial abdominal ultrasound reviled an inhomogeneous mass surrounding the left kidney. Subsequent CT examination of the abdomen showed four separate, extrarenal, well-circumscribed, round-shaped, fat-containing retroperitoneal tumors. Given the significant size of the masses, that compressed major abdominal vessels and the suspicion of liposarcoma, a surgical excision of the lesions was performed. The tumors were easily separated, all surrounding structures were spared, and they were removed completely. Histologically, all masses consisted of hematopoietic and mature fat tissue and the final diagnosis was extra-adrenal myelolipoma. The patient was released from the hospital 7th day after surgery in good condition and at his baseline. Since myelolipomas are, by definition, nonfunctional benign tumors, there was no need for further follow-up. The radiological evaluation and fine needle biopsy are usually sufficient to establish the diagnosis, but in some cases of well-differentiated liposarcoma, the differentiation between myelolipoma and liposarcoma can be challenging. Therefore, considering that myelolipomas and liposarcomas have opposite prognoses, which affects the surgeon’s decision on the extent of surgical procedure and further treatment, we also emphasize the importance of intraoperative assessment of the tumor, both by the surgeon and by intraoperative pathology consultation.
机译：额外的肾上腺髓样是罕见的无症状的实体，尽管大肿瘤可能导致局部症状或出血。当这些病变发生在逆转录体中的肾上腺外，它们是射线照相容易与初级和次级腹膜内肿瘤混淆，这往往是侵略性的。虽然肌肌脂磷瘤是良性的，并且可以保守，如果怀疑恶性，则手术程序是一种选择。我们举报了一个68岁患者的患者，具有多发性肾上腺骨髓肌醇胶质瘤。初始腹部超声旋转左肾周围的不均匀质量。随后的CT检查腹部显示出四个单独的，外侧，均匀的圆形圆形型含脂肪的腹膜肿瘤。鉴于大规模的群体大小，对压缩的主要腹部血管和脂肪糖瘤的怀疑，进行了病变的手术切除。肿瘤容易分开，静置所有周围结构，完全除去它们。组织学上，所有群众由造血和成熟的脂肪组织组成，最终诊断是肾上腺髓脂瘤。患者在手术后第7天从医院释放，良好的条件和基线。由于敏龙液根据定义，无官能良性肿瘤，因此不需要进一步随访。放射性评估和细小针活检通常足以建立诊断，但在某些情况下，在一些良好分化的脂质瘤中，肌脂肪瘤和脂肪瘤之间的分化可能是挑战性的。因此，考虑到髓样瘤和脂肪瘤具有对立面的预期，这影响了外科医生关于外科手术程度和进一步治疗程度的决定，我们还强调了外科医生和术中病理咨询的肿瘤术中评估的重要性。

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