1/129. Dendritic cell-based immunotherapy of renal cell carcinoma.dendritic cells potently stimulate antigen-specific immune responses and recent data indicate that they are also capable of eliciting antitumor immune responses. We are performing a pilot study which tests the safety and efficacy of antigen-loaded, cultured blood dendritic cells in patients with metastatic renal cell carcinoma. dendritic cells are simultaneously pulsed with lysate from autologous tumor cells and with the immunogenic protein keyhole limpet hemocyanin. During the pulse, the cells are activated with a combination of tumor necrosis factor-alpha and prostaglandin E2. patients receive 5-10 X 10(6) dendritic cells per intravenous infusion and up to six infusions at monthly intervals. The first results demonstrate that this treatment modality is very well tolerated and can be associated with strong immunological and clinical responses. The present article discusses the importance of dendritic cell maturation and the role of helper antigens in dendritic cell-based immunotherapy.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/129. A rare combination consisting of primary hyperaldosteronism and glucagonoma.A 59-yr-old man with multiple pancreatic tumors is presented. Previously, he had undergone left adrenalectomy for primary hyperaldosteronism and left nephrectomy for renal cell carcinoma at the ages of 39 and 55 yr, respectively. This time, 3 yr after removal of renal cancer, two solid lesions in the pancreas associated with hyperglucagonemia were detected. Under a diagnosis of pancreatic metastasis from renal cell carcinoma or islet cell tumor of the pancreas, distal pancreatectomy with splenectomy and enucleation of the tumor in the pancreas head were performed. Microscopically, a glucagonoma, measuring 2.3 mm in diameter, was detected among five pancreatic metastases from renal cell carcinoma. Four years after surgery, the patient remains well, without signs of recurrence despite multiple pancreatic metastases. This is the first report of such a rare combination consisting of aldosterone-secreting adrenal adenoma and glucagonoma.- - - - - - - - - - ranking = 11.434564234228keywords = adrenal (Clic here for more details about this article) |
3/129. Extra-adrenal phechromocytoma and renal cell carcinoma--an unusual case of tumour synchronism.We report an unusual case of tumour synchronism combining an extra-adrenal pheochromocytoma and a renal cell carcinoma in a 48-year-old male. The most usual forms of presentation are described in accordance with their clinical significance. We emphasize the diagnostic importance of specific biochemical studies and the accurate anatomical localization of extra-adrenal chromaffin tissue by magnetic resonance imaging (MRI) and scintigraphy with 131 iodine-methyliodobenzylguanidine (131I-MIBG). Surgical excision was the treatment of choice after the institution of adequate preoperative cardiovascular management. Pertinent features of the natural history of these tumours are described in accordance with their different embryological origin.- - - - - - - - - - ranking = 34.303692702683keywords = adrenal (Clic here for more details about this article) |
4/129. Collecting duct meningeal carcinomatosis.Collecting duct carcinoma (CDC) is an aggressive primary renal neoplasm that represents a distinct subtype of renal cell carcinoma. Histochemical (eg, mucicarmine) and immunohistochemical (eg, ulex europaeus) studies, taken in concert with the gross and histologic findings, allow differentiation of CDC from the conventional varieties of renal cell carcinoma in most cases. Collecting duct carcinoma generally pursues a more aggressive course than conventional renal cell carcinoma. Metastases to regional lymph nodes, bone, adrenal glands, lung, and skin have been reported in CDC. We describe the case of a 26-year-old man who presented with a clinical and radiologic impression of multifocal meningioma. Biopsies of the meninges and extracranial soft tissues revealed metastatic adenocarcinoma; subsequent studies suggested metastatic CDC. Ultrasound-guided biopsy was performed on a subsequently identified renal mass, which showed features consistent with CDC. To our knowledge, this is the first reported case of meningeal carcinomatosis due to CDC. The diagnostic features of this tumor are discussed.- - - - - - - - - - ranking = 42.966179044429keywords = adrenal gland, adrenal, gland (Clic here for more details about this article) |
5/129. Renal cell carcinoma metastasizing to the thyroid gland.Renal cell carcinoma represents 3% of all adult malignancies. Metastases occur most frequently in the bone and lung. Four cases of renal cell carcinoma metastasizing to the thyroid gland are described here. A literature review is presented and guidelines for the management of this rare condition are suggested.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
6/129. Differential diagnosis between monomorphic clear cell adenocarcinoma of salivary glands and renal (clear) cell carcinoma.Clear cell adenocarcinoma of salivary glands (CCASG) is a relatively rare tumor, composed entirely of clear cells of putative ductal origin. It bears striking morphologic similarities to renal cell carcinoma (RCC) of clear cell type on hematoxylin and eosin stains. Differentiation between CCASG and metastatic RCC to the salivary glands has been considered problematic or even impossible on morphologic grounds. We examined three cases of CCASG and 12 cases of RCC (6 primary and 6 metastatic) by hematoxylin and eosin staining, immunohistochemistry, and electron microscopy. Two distinctive immunohistochemical and ultrastructural patterns emerged from this analysis. CCASG showed positivity for high molecular weight cytokeratin and carcinoembryonic antigen and ultrastructurally showed prominent squamoid differentiation, glycogen pools, and absence of lipid. In contrast, RCC was characterized by positivity for vimentin and complete absence of staining for high molecular weight cytokeratin and carcinoembryonic antigen. On ultrastructural studies, RCC lacked any squamoid differentiation, and the tumor cells contained abundant cytoplasmic lipid in addition to glycogen. Thus, based on the consistent differences on the immunohistochemical staining patterns and their characteristic subcellular morphology, CCASG and RCC can be distinguished on pathologic evaluation. The different direction of differentiation of the cells in CCASG and RCC (i.e., ductal in the former and renal tubular and mesodermal in the latter) results in their distinctive immunophenotypical and ultrastructural features.- - - - - - - - - - ranking = 6keywords = gland (Clic here for more details about this article) |
7/129. Scintigraphic demonstration of renal cell carcinoma with I-131-6beta-iodomethyl-19-norcholesterol: a case report.Extraadrenal abnormal uptake on adrenocortical scintigraphy has been reported rarely in the normal gallbladder, lipid cell tumor of the ovary, or in clear cell type renal cell carcinoma. Clear cell type renal cell carcinoma contains glycogen and cholesterol like the adrenal gland, but the uptake of the radionuclide I-131 cholesterol has been reported to be low and not sufficient to image it. Right renal and adrenal masses were incidentally discovered on abdominal CT scan in a patient with chronic renal failure resulting in bilateral acquired cystic kidney disease. Adrenocortical scintigraphy done to know the nature of the adrenal mass showed high uptake corresponding to the right renal mass and the right adrenal mass. Clear cell type renal cell carcinoma and adrenal adenoma with prominent clear cells were histologically confirmed on hematoxylin-eosin stain and in an immunohistochemical study with renal cell antibody. Not only low-density lipoprotein receptors mediated uptake but also overall replacement of the right non-tumorous renal parenchyma by acquired cysts may have played a role in imaging the renal cell carcinoma on adrenocortical scintigraphy.- - - - - - - - - - ranking = 71.552589629999keywords = adrenal gland, adrenal, gland (Clic here for more details about this article) |
8/129. The role of surgery in renal cell carcinoma with solitary metachronous metastasis to contralateral adrenal gland.We report a case of renal cell carcinoma with solitary metachronous metastasis to contralateral adrenal gland occurring 9 months after radical nephrectomy. The patient was treated with a contralateral adrenalectomy and is alive for 87 months. The literature was reviewed and 5-year survival of solitary metachronous metastasis to contralateral adrenal gland was 60%. Follow-up duration of our case was the longest in the literature. It is suggested that the solitary contralateral adrenal gland metastasis of renal cell carcinoma should be resected since there is no effective treatment of metastatic renal cell carcinoma. Good prognosis may be then and the good be expected.- - - - - - - - - - ranking = 306.48053542812keywords = adrenal gland, adrenal, gland (Clic here for more details about this article) |
9/129. Solitary metachronous contralateral adrenal metastasis from renal cell carcinoma.Malignant involvement of the contralateral adrenal gland in cases of renal cell carcinoma is extremely rare. We report a case of solitary metachronous contralateral adrenal metastasis occurring 7.5 years after radical nephrectomy. The metastasis was treated with adrenalectomy and steroid replacement. Thirty months later, the patient remained without evidence of disease. This very rare presentation can prove to be a diagnostic challenge. Appropriate aggressive surgical treatment is warranted.- - - - - - - - - - ranking = 77.269871747112keywords = adrenal gland, adrenal, gland (Clic here for more details about this article) |
10/129. Solitary metastasis of renal cell carcinoma to the contralateral adrenal gland 22 years after nephrectomy.A case of solitary metastasis to the contralateral adrenal 22 years after radical nephrectomy for renal cell carcinoma (RCC) is described. This case highlights the variable behavior of RCC, the tendency for adrenal metastasis, and the potential for prolonged survival after resection of late solitary metastases.- - - - - - - - - - ranking = 183.29928041194keywords = adrenal gland, adrenal, gland (Clic here for more details about this article) |
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