妊娠肾上腺囊肿伴出血报道1例并文献分析

Pregnancy Adrenal Cyst with Hemorrhage: A Case Report and Literature Analysis

摘要: 肾上腺囊肿是一种良性病变，在临床上并不常见。一般无明显临床症状和体征。通常在影像学诊断、手术或尸解中意外发现。妊娠期合并肾上腺囊肿比较罕见，在没有出现并发症时，常表现为盆腔包块，确定囊肿起源时有时具有挑战性，这给临床医生带来了诊断上和治疗上的困难。一名26岁孕妇在孕14周零4天出现腹部胀痛1月余入院。超声显示患者右上腹约有20 cm的囊实性包块。肿瘤标志物及其它实验室检查均正常。MRI检查显示右上腹腹膜后囊实性巨大肿块，合并出血。计划进行剖腹手术。在剖腹手术中，观察到左侧上腹部腹膜后直径约20 cm囊性为主包块，子宫和双侧附件未见明显异常，囊肿起源于右肾上腺并切除。

Abstract: Objective: Adrenal cysts are benign lesions that are not common in clinical practice, generally no obvious clinical symptoms and signs. It is usually found by accident during radiographic diagnosis, surgery, or autopsy. Adrenal cysts during pregnancy are rare and often present as pelvic masses in the absence of complications. Determining the origin of cysts is sometimes challenging, which poses diagnostic and therapeutic difficulties for clinicians. A 26-year-old pregnant woman developed ab-dominal distension at 14 weeks and 4 days of gestation more than 1 month after admission. Ultra-sound revealed a cysticular mass of about 20 cm in the right upper abdomen. Tumor markers and other laboratory tests were normal. MRI examination revealed a large posterior peritoneal cystic mass with hemorrhage. A laparotomy is planned. During laparotomy, a cystic mass with a diameter of about 20 cm was observed in the left epigastric retroperitoneal mass. No obvious abnormalities were observed in the uterus and bilateral adnexa. The cyst originated from the right adrenal gland and was excised.