腎上腺罕見淋巴血管瘤之手術案例報告

陳生文、陳嘉宏、張彰琦、陳修聖

台北市立聯合醫院忠孝院區外科部泌尿科

Surgical experience of adrenal lymphangioma: Mimicking adrenal tumor on image

Sheng-Wen Chen, Chia-hung Chen, Chang-Chi Chang, Shiou-Sheng Chen

Division of Urology, Department of Surgery, Taipei City Hospital Zhongxiao branch

Introduction:

    Adrenal lymphangioma is a very rare benign lesion and remains challenging to distinguish it from adrenal malignancy on image. We present with an surgical management scenario that a 44 year old female with past history of left renal stone. Left cystic mass lesion was found incidentally during routine renal ultrasound examination. We present the laparoscopic lateral transperitoneal approach of left adrenal cystic lymphangioma in our hospital.

Case presentation: 

This 44 year old women who had bilateral renal stones followed in our OPD. Left renal cyst was found incidentally on kidney ultrasound. We further arranged enhanced abdominal computed tomography and magnetic resonance imaging for further evaluation. A 37x70x67mm multilobulated cystic lesion was found at left suprarenal region. Laboratory examination for adrenal metabolic survey was arranged and all value were in normal limitation. Left laparoscopic lateral transperitoneal approach for left adrenalectomy was then scheduled. Microscopically, the tumor stroma is fibrotic, with focal calcification and lymphocyte infiltration. Immunohistochemical study demonstrated the immunostaining characteristic of lymphangioma.

Conclusion:

    Although metabolic inactive adrenal cystic lymphangioma is rare benign lesion. It should be considered in the differential diagnosis of adrenal malignancy due to similar imaging features with original or metastatic mass lesions.