目的: 报道1例原发性肾上腺黑色素瘤(PAM)病例,回顾国内外该病有关文献并总结该病临床特征及治疗方法。方法: 分别在中国知网数据库、万方数据、PubMed中,以"肾上腺黑色素瘤""adrenal melanoma""primary melanoma"为关键词,检索并纳入建库以来至2022年2月发表的文献16篇,包括本报道的1例患者共纳入PAM患者17例,总结分析该病的临床特征。结果: PAM在临床上极为罕见,其症状与影像表现无特异性,临床容易误诊,组织病理及免疫组化是该病诊断的金标准。结论: PAM恶性程度高,预后较差,目前尚无标准治疗方案。术中行局部广泛切除,术后给予化疗及免疫治疗,同时对转移灶进行切除可能是一种有效延长患者生存期的治疗方法。

[1] DICK J C,RITCHIE G M,THOMPSON H.Histological differentiation between phaeochromyocytoma and melanoma of the suprarenal gland[J].J Clin Pathol,1955,8(2):89-98.
[2] SASIDHARAN K,BABU A S,PANDEY A P,et al.Primary melanoma of the adrenal gland:a case report[J].J Urology,1977,117(5):663-664.
[3] CARSTENS P H B,KUHNS J G,GHAZI C.Primary malignant melanomas of the lung and adrenal[J].Hum Pathol,1984,15(10):910-914.
[4] PARKER L A,VINCENT L M.Detection of adrenal melanomawith computed tomography[J].Urol Radiol,1986,8(1):209-210.
[5] DAO A H,PAGE D L,REYNOLDS V H,et al.Primary malignant melanoma of the adrenal gland.A report of two cases and review of the literature[J].Am Surg,1990,56(4):199-203.
[6] 吴天,阎建华,孙俊杰,等.左侧肾上腺恶性黑色素瘤一例[J].中华放射学杂志,2000,34(8):573-574.
[7] AMERIGO J,ROIG J,PULIDO F,et al.Primary malignant melanoma of the adrenal gland[J].Surgery,2000,127(1):107-111.
[8] ZALATNAI A,SZENDE B,TOTH M,et al.Primary malignant melanoma of adrenal gland in a 41-yr-old woman[J].Endocr Pathol,2003,14(1):101-106.
[9] GRANERO L E,AL-LAWATI T,BOBIN J Y.Primary melanoma of the adrenal gland,a continuous dilemma:report of a case[J].Surg Today,2004,34(6):554-556.
[10] LIATSIKOS E N,PAPATHANASSIOU Z,VOUDOUKIS T,et al.Case report:laparoscopic adrenalectomy in a patient with primary adrenal malignant melanoma[J].J Endourol,2006,20(2):123-126.
[11] BASTIDE C,ARROUA F,CARCENAC A,et al.Primary malignant melanoma of the adrenal gland[J].Int J Urol,2006,13(5):608-610.
[12] GONZÁLEZ-SÁEZ L,PITA-FERNÁNDEZ S,LORENZO-PATIÑO M J,et al.Primary melanoma of the adrenal gland:a case report and review of the literature[J].J Med Case Rep,2011,5(1):273-280.
[13] AVGERINOS D V,NAZARIAN M,SCHERR D S,et al.Primary adrenal melanoma with inferior vena caval thrombus[J].Ann Thorac Surg,2012,94(6):2108-2110.
[14] EJAZ S,SHAWA H,HENDERSON S A,et al.Melanoma of unknown primary origin presenting as a rapidly enlarging adrenal mass[J/OL].BMJ Case Rep(2013-06-19)[2022-07-10].https://casereports.bmj.com/content/2013/bcr-2013-009727.
[15] XU B,HONG Y,JIN M,et al.Primary adrenal malignant melanoma:a case report and review of literature[J].Medicine(Baltimore),2017,96(51):e8956.
[16] 陈方敏,姜锡男,钟思文,等.肾上腺原发性恶性黑色素瘤一例报告[J].中华泌尿外科杂志,2018,39(9):708.
[17] 郑清友,许先有,狄桂萍,等.肾上腺转移癌的诊治[J].中华泌尿外科杂志,2010,31(12):803-805.
[18] LALLIER T E.Cell lineage and cell migration in the neural crest[J].Ann N Y Acad Sci,1991,615(1):158-171.
[19] CHETTY R,CLARK S P,TAYLOR D A.Pigmented pheochromocytomas of the adrenal medulla[J].Hum Pathol,1993,24(4):420-423.
[20] PAGES A,MARTY-DOUBLE C.Histopathologie endocrinienne[M].Paris:Masson,1977:183-184.
[21] MACLACHLAN W W G.Primary melano-sarcoma of the adrenals[J].J Med Res,1915,33(1):93-106.
[22] OTAL P,ESCOURROU G,MAZEROLLES C,et al.Imaging features of uncommon adrenal masses with histopathologic correlation[J].Radiographics,1999,19(3):569-581.
[23] 陈星荣,沈天真,段承祥,等.全身CT和MRI[M].上海:上海医科大学出版社,1994:245.
[24] HOLDER W D,WHITE R L,ZUGER J H,et al.Effectiveness of positron emission tomography for the detection of melanoma metastases[J].Ann Surg,1998,227(5):764-771.
[25] VISSER J W,BOEIJINGA K D,MEER C V.A functioning black adenoma of the adrenal cortex:a clinico-pathological entity[J].J Clin Pathol,1974,27(12):955-959.
[26] AINSWORTH A M,CLARK W H,MASTRANGELO M,et al.Primary malignant melanoma of the urinary bladder[J].Cancer,1976,37(4):1928-1936.
[27] DASGUPTA T K,BRASFIELD R D,PAGLIA M A.Primary melanomas in unusua sites[J].Surg Gynecol Obstet,1969,128(4):841-848.