1/691. neuroblastoma metastatic to the liver in infants.Four infants are described who presented with rapid enlargement of the liver. This was found to be due to neuroblastoma which had metastasized to the liver; the condition was associated with high levels of urinary vanillylmandelic acid (VMA). In 3 infants the primary tumour was in the adrenal gland and in one it was not identified. One infant died after laparotomy and 2 infants survive disease free with normal VMA levels, one after adrenalectomy and hepatic irradiation and one after a short course of chemotherapy. The fourth patient responded initially to hepatic irradiation and chemotherapy, but relapsed 2 years later with recurrent disease; at the same time the VMA level which had been normal, again rose. The importance of screening for an abnormal VMA level in any infant with a rapidly enlarging liver in order to obtain an early diagnosis is stressed. Careful follow-up, with serial VMA estimations, is essential to detect recurrent disease. The prognosis for some infants with this distribution of neuroblastoma which has metastasized to the liver, but not to the bones or oribt, is good.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/691. MR imaging of a case of adenomatoid tumor of the adrenal gland.The aim of this case report is to describe the appearance on magnetic resonance imaging (MRI) of an incidentally found adenomatoid tumor of the adrenal gland, and to evaluate the utility of MRI in characterizing this type of tumor. The appearance of the tumor was nonspecific on T1-weighted in-phase, opposed-phase, and T2-weighted images, as well as its behavior after paramagnetic contrast administration, outlining the differential diagnosis among carcinoma, metastatic tumors, and pheochromocytoma. After surgery, the pathologic diagnosis was adenomatoid benign tumor of mesothelial origin. Although MRI enables the characterization of most benign lesions of the adrenal gland, the appearance of other lesions is nonspecific. In our case, MRI did not assist in preoperative diagnosis, guiding us towards a diagnosis of malignancy.- - - - - - - - - - ranking = 6keywords = gland (Clic here for more details about this article) |
3/691. Fine needle aspiration diagnosis of extraadrenal myelolipoma presenting as a pleural mass. A case report.BACKGROUND: myelolipoma is a benign tumor composed of mature adipose tissue and hematopoietic cells. Although they are commonly found in adrenal glands, extraadrenal myelolipomas (EMLs) are rare but well documented. They have been found in various sites, including mediastinum, liver, stomach, lungs, pelvis, spleen, retroperitoneum, presacral region and mesentery. EMLs must be distinguished from extramedullary hematopoieses, which are also composed of hematopoietic elements but may lack adipose tissue and are associated with anemia and marked bone marrow hyperplasia. CASE: We describe a case of a pleura-based, extraadrenal myelolipoma in a 53-year-old female with unremarkable bone marrow findings that were initially encountered on fluoroscopy-guided fine needle aspiration (FNA). One year later the mass was removed via open thoracotomy. It showed typical EML features histologically. CONCLUSION: EML manifests on aspiration cytology as a cellular specimen with numerous trilineage hematopoietic cells and a variable proportion of mature adipose cells. To our knowledge, FNA cytology of EML has not been found in this location before. Aspiration biopsy offers a simple and reliable method for the diagnosis of EML in the presence of appropriate clinical settings.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
4/691. Hypoglycaemia induced by adrenal gland neoplasia (Anderson's syndrome) : report of a case.A patient with hypoglycaemia associated with an adrenal neoplasia (Anderson's syndrome) is reported. Endocrinological investigation showed increased secretion of cortisol and catecholamines as well as an increased urinary steroid excretion along with profound inhibition of both basal and stimulated insulin secretion. During IVGTT, Conard's coefficient was reduced. The hyperglycemic response to glucagon injection was blunted, suggesting that liver glycogen stores were decreased or unavailable.- - - - - - - - - - ranking = 4keywords = gland (Clic here for more details about this article) |
5/691. Long-term survival after extended surgical resection of melanoma metastasis and immunotherapy.A patient with a huge melanoma metastasis to the left adrenal gland was treated by multivisceral surgical resection. Progression of disease could be controlled by systemic immunotherapy resulting in long-term survival. In selected cases, above all with late manifestation of distant melanoma metastases, even major surgical resection of such lesions can be worthwhile.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
6/691. Management of adrenal metastasis of hepatocellular carcinoma by asynchronous resection of bilateral adrenal glands.We report on a 65-year-old man who received asynchronous bilateral adrenalectomy for adrenal metastasis of hepatocellular carcinoma. Fifteen months after curative resection of right hepatic lobe for hepatocellular carcinoma, a metastatic lesion of the left adrenal gland was detected and left adrenalectomy was performed. Ten months after the second operation, a metastatic lesion in the right adrenal gland, associated with tumor thrombus in the inferior vena cava, was revealed. Transcatheter arterial embolization of the arteries feeding the metastatic tumor was performed, but its effects were incomplete. As there was the tumor thrombus in the inferior vena cava and no other intrahepatic recurrence or extrahepatic metastasis was found, resection of the right adrenal gland with tumor thrombus, without the employment of veno-venous bypass, was performed, followed by postoperative hormonal supplementation. Changes in the patient's alpha-fetoprotein level were clinically useful for the detection of the metastatic lesions and the evaluation of therapeutic effects. Metastasis to adrenal gland from hepatocellular carcinoma should be actively managed, and the appropriate surgical treatment selected, if intrahepatic recurrence and/or other extrahepatic metastasis are controlled. To achieve higher curability and better outcome in patients with bilateral adrenal metastasis of hepatocellular carcinoma, bilateral total adrenalectomy is indicated, accompanied by effective postoperative hormonal supplementation.- - - - - - - - - - ranking = 8.000134277628keywords = gland, lobe (Clic here for more details about this article) |
7/691. adrenal insufficiency caused by primary aggressive non-Hodgkin's lymphoma of bilateral adrenal glands: report of a case and literature review.A 64-year-old woman was hospitalized because of poor general condition, gastrointestinal upset, unexplained fever, electrolyte imbalances, and an incidental finding of bilateral huge adrenal masses on computerized tomography (CT) of the abdomen. Non-Hodgkin's lymphoma (NHL) of B-cell origin was proven by ultrasound-guided aspiration biopsy of the left adrenal gland. Meanwhile, primary adrenal insufficiency was confirmed by her low serum cortisol level, high ACTH level, and inadequate adrenal response to the rapid ACTH stimulation test. The diagnosis of primary adrenal NHL was supported by detailed physical examinations, bone marrow examination, and such imaging studies as CT scan and sonography. She received three courses of chemotherapy with cyclophosphamide, vincristine, and prednisolone and there was an initial transient response, but she died of sepsis and progression of NHL three and a half months later.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
8/691. Bilateral cystic lymphangioma of the adrenal gland.We report the case of a 22-year-old woman with a large, bilateral lymphangiomatous cyst originating from the adrenal glands. Since she was having persistent pain and the diagnosis was uncertain, we did surgery.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
9/691. myocardial infarction and death after caesarean section in a woman with protein s deficiency and undiagnosed phaeochromocytoma.We describe the case of a 36-year-old woman, with a previous history of recurrent abortion due to protein s deficiency, undergoing an elective Caesarean section at 39-weeks gestation. During pregnancy no signs of hypertension or cardiovascular disease were reported, but at the end of the surgical procedure, the patient developed acute hypertension, leading to myocardial infarction, severe heart failure and death. The autopsy revealed a 2-cm undiagnosed phaeochromocytoma in the right adrenal gland. Clinical diagnostic features of phaeochromocytoma during pregnancy as well as the main therapeutic approaches suggested in the literature are discussed.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
10/691. carcinoma of the thyroid gland, adenoma of the adrenal cortex and peptic ulcer: an unreported association.A 39-year-old man, operated on for duodenal ulcer, was found to have a papillary carcinoma of the thyroid, an aldosterone-producing adenoma of the adrenal cortex, and a recurrence of a peptic ulcer. The probable coincidental occurrence of these diseases in this patient is suggested. Nevertheless, careful investigation of the other endocrine glands in patients with endocrine tumors is recommended.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
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