成人の無症候性副腎出血の1例

Abstract

67歳女性.健診で左副腎の腫瘤を指摘され, 前医のCTで5.5cm大の副腎腫瘤を認め紹介入院となった.内分泌学的検査では明らかな異常は認めなかったが, CTで左副腎に5.5cm大で辺縁整, 円形の腫瘤を認め, 早期より辺縁を中心に不均一に造影効果があった.また, MRIではT1強調で低信号, T2強調で不均一な高信号を示したが, 確定診断が得られず, ミニマム創・内視鏡下経腰的左副腎摘除を施行した.摘出標本は表面平滑, 割面は赤褐色で中心部が白色の血腫様で, 病理組織所見では器質化と石灰沈着を一部に生じており, 亜急性から慢性期に相当の血腫で, 副腎髄質からの出血と考えられた.なお, 腫瘍細胞は認めず, 中心の白色部分は成熟脂肪細胞の集団であった

A 67-year-old woman underwent abdominal ultrasonography as part of a general health examination and was incidentally found to have a mass 5 cm in diameter in the left adrenal gland. She had no experience of abdominal trauma. Computerized tomography (CT) revealed a 5.5 x 5.0 cm mass in the left adrenal gland, which was heterogeneously enhanced by the contrast medium. Hormanal data for adrenal function were all within the normal range. For the suspected non-functioning adrenal tumor, the patient underwent adrenalectomy. Histopathological examination demonstrated only hematoma without tumor cells.