副腎石灰化線維性偽腫瘍の1例  [in Japanese] A CASE REPORT OF CALCIFYING FIBROUS PSEUDOTUMOR OF THE ADRENAL GRAND  [in Japanese]

石灰化線維性偽腫瘍は通常は四肢,体幹,腋窩,肋膜,縦隔と腹膜の軟組織に発生する病理学的に特異な腫瘍である.今回副腎石灰化線維性偽腫瘍の1例を経験したので報告する.症例は29歳女性.左腰痛を主訴に近医受診し,CTで左副腎腫瘍を指摘された.採血上生化学・ホルモン学的に異常はなかったが,尿中カテコールアミンではノルアドレナリンとドーパミンのみ高値を認めた.画像上,副腎癌や褐色細胞腫は否定できなかったが,典型的な所見はなく,副腎シンチ(I^<131>アドステロール)でも有意な取り込みは認められなかった.悪性の可能性を否定できず腹腔鏡下左副腎摘出術を行い,病理学的に副腎石灰化線維性偽腫瘍と診断された.副腎石灰化線維性偽腫瘍は,我々が調べた限りでは海外の報告例も含め4例目で本邦1例目であると考えられた.

Calcifying fibrous (pseudo) tumour (CFP) is an uncommon and distinct pathological entity, which is usually occurring in the soft tissue of the extremities, trunk, axilla, pleura, mediastinum and peritoneum. We report a case of CFP of the adrenal gland. A 29-years-old previously healthy woman complained the left lumbago. A solid mass was found on computed tomography on the left adrenal gland. There were no abnormalities in physical examination and laboratory studies. Only urinary noradrenalines and dopamines levels were slightly high. Laparoscopic left adrenalectomy was performed. Pathological findings of the left adrenal tumor showed dense hyalinized fibrous tissue containing bland spindle-shaped cells, calcifications, and lymphoplasmacytic infiltrate. Our case seems to be the first case of CFP to be published in the Japanese literature.