1/15. A case of "silent" pheochromocytoma presenting as spontaneous retroperitoneal hematoma.pheochromocytoma of the adrenal gland can be the cause of massive and lethal retroperitoneal haemorrhage presenting as acute abdomen. Here we report a case of retroperitoneal hematoma, with concomitant peritoneal spillage, due to the spontaneous rupture of a silent pheochromocytoma. The main clinical findings of this disease will be described. Therapy and prognosis will be also discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/15. Adrenal myelolipoma presenting with spontaneous retroperitoneal haemorrhage demonstrated on computed tomography and angiogram--a case report.INTRODUCTION: A rare case of adrenal myelolipoma presenting with spontaneous rupture and retroperitoneal haemorrhage is described. CLINICAL PICTURE: A 51-year-old Caucasian male presented with acute onset of right loin pain. Preliminary diagnosis of haemorrhagic adrenal tumour was made on computed tomography (CT) and angiography. TREATMENT: Vascular embolisation was performed to stabilise the patient prior to definitive surgery. Tumour resection was subsequently performed. histology confirmed ruptured adrenal myelolipoma. OUTCOME: The patient made an uneventful recovery. CONCLUSION: Ruptured adrenal myelolipoma should be considered in cases of spontaneous retroperitoneal haemorrhage. Vascular embolisation may be useful in stabilising the patient prior to definitive surgery.- - - - - - - - - - ranking = 6keywords = haemorrhage (Clic here for more details about this article) |
3/15. Bilateral adrenal cystic neuroblastoma with superior vena cava syndrome and massive intracystic haemorrhage.Bilateral cystic adrenal tumours are a rare presentation of neuroblastoma. Intratumoural haemorrhage is a frequent finding in neuroblastoma, but is rarely symptomatic. We present an 11-month-old girl with predominantly cystic bilateral neuroblastomas and distant lymph-node metastasis. Massive intracystic haemorrhage and superior vena cava (SVC) syndrome were ominous prognostic factors, leading to death. Large tumours with intracystic haemorrhage might require a conservative approach.- - - - - - - - - - ranking = 7keywords = haemorrhage (Clic here for more details about this article) |
4/15. Adrenal metastases of malignant melanoma: characteristic computed tomography appearances.Malignant melanoma is an extremely aggressive form of cancer. Adrenal metastases are found in 50% of cases of malignant melanoma, and are most often clinically and biochemically silent. Clinical presentation varies, and the diagnosis of adrenal metastases is often made incidentally, and frequently years after treatment of the primary lesion. An adrenal mass lesion seen on a CT scan, greater than 5 cm in diameter, with central or irregular areas of necrosis/haemorrhage (and no lipomatous component) is characteristic of a metastasis from malignant melanoma, in the setting of normal gland function. If these features are bilateral, they are pathognomonic. Oval, low-attenuation (on CT) adrenal masses less than 3 cm in diameter should not be considered benign in a patient with any prior history of melanoma. Careful imaging review of the adrenal glands should be undertaken in all patients with malignant melanoma. early diagnosis of these distant metastases has important prognostic and therapeutic implications. The four cases presented illustrate the spectrum of presentations and clinical course of adrenal metastases from malignant melanoma. The accompanying CT images show the characteristic appearances of adrenal metastases.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
5/15. Spontaneous intracerebral haemorrhage caused by extra-adrenal phaeochromocytoma.We report an 18-year-old man who presented with a sudden onset of headache followed by left hemianopia. A brain CT scan showed intracerebral haemorrhage in the left frontoparietal area, but a cerebral angiogram and MRI revealed no vascular anomaly. The patient was managed conservatively and his headache and visual loss improved over time. hypertension in the form of paroxysmal attacks led us to suspect phaeochromocytoma. Subsequently, the patient was diagnosed with an extra-adrenal phaeochromocytoma in the left para-aortic area following endocrinological evaluation, abdominal CT scan and (131)I-meta-iodobenzylguanidine (MIBG) scintigraphy. The patient presented here illustrates the importance of a careful search for a remediable cause of hypertension in children and young adults with spontaneous intracerebral haemorrhage.- - - - - - - - - - ranking = 6keywords = haemorrhage (Clic here for more details about this article) |
6/15. Hypertensive primary intraventricular hemorrhage due to a phaeochromocytoma.Primary intraventricular haemorrhage (IVH) is rare. We defined primary IVH as haemorrhage into the ventricles only as detected by computerized tomographic (CT) brain scan. This is in contrast with other intracerebral haemorrhages (e.g. basal ganglia/thalamic with intraventricular extension). The clinical condition of the patient ranges from minimal neurological deficits to coma/death. It also carries with it a poor prognosis of up to 80% when all four ventricles are involved. We present a 45-year-old Chinese female who presented with a hypertensive IVH which was managed successfully with ventricular drainage and intraventricular urokinase therapy. An adrenal phaeochromocytoma was diagnosed which was subsequently removed laparoscopically. The patient has recovered well in all aspects. This case report will discuss management of IVH and the importance of searching for secondary causes of hypertension.- - - - - - - - - - ranking = 3keywords = haemorrhage (Clic here for more details about this article) |
7/15. multiple endocrine neoplasia type 2b: long-term follow-up of a case.multiple endocrine neoplasia type 2b is a rare inherited syndrome which comprises the association of medullary thyroid carcinoma, phaeochromocytoma, widespread neuromatous proliferation and a characteristic body habitus. In this report we present the late clinical course and autopsy findings of the first patient with this syndrome described in australia. At presentation she was found to have a right adrenal phaeochromocytoma and medullary thyroid carcinoma which were resected in separate operations. No clinical or biochemical evidence of residual medullary thyroid carcinoma was identified in life. However, in spite of serial vanillylmandelic acid estimations, which showed normal or only mildly elevated levels, and normal results of urinary catecholamine studies, a left adrenal phaeochromocytoma was identified in a metaiodobenzylguanidine (MIBG) study performed 14 years after presentation. Her late clinical course was dominated by progressive dysphagia, intestinal dysmotility and megacolon associated with unrelenting malnutrition. After her death due to an intracerebral haemorrhage, an autopsy confirmed the presence of a left adrenal phaeochromocytoma and revealed diffuse intestinal ganglioneuromatosis to be the cause of her intestinal dysmotility. No residual medullary thyroid carcinoma was found. This case emphasises the propensity for multiple endocrine tumours in these patients and highlights the potentially significant role of intestinal ganglioneuromatosis in the natural history of this condition.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
8/15. Cerebral haemorrhage in a pregnant woman with a multiple endocrine neoplasia syndrome (type 2A or Sipple's syndrome).We present the case history of a 30-yr-old woman who suffered a cerebral haemorrhage toward the end of pregnancy (at 35 wk). The pregnancy was terminated by Caesarean section because aggravation of cerebral bleeding was feared. Extensive studies revealed that the patient was suffering from a multiple endocrine neoplasia syndrome (type 2A or Sipple's syndrome) with bilateral pheochromocytomas and a medullary thyroid carcinoma. She made an uneventful recovery. The relevant literature is discussed.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
9/15. Massive adrenal haemorrhage complicating adrenal neoplasm.Two patients presented to hospital with clinical features of acute retroperitoneal haemorrhage. In each case, laparotomy revealed massive adrenal haemorrhage, and histological evidence of underlying neoplasia was eventually found.- - - - - - - - - - ranking = 6keywords = haemorrhage (Clic here for more details about this article) |
10/15. Phaeochromocytoma and acute cardiovascular death (with special reference to myocardial infarction).The causes of death, as determined by autopsy, in 10 patients dying from the acute effects of phaeochromocytoma were myocardial infarction (five patients), left ventricular failure (two patients), cerebral haemorrhage (two patients) and circulatory collapse with malignant phaeochromocytoma (one patient). Most patients died shortly after admission during the course of a fulminant cardiovascular illness and the underlying tumour was unsuspected in eight instances. The clinical features and post-mortem cardiovascular findings are reviewed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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