11/15. Are the clinically important adrenal cysts hamartomas?An adrenal cyst in a 36-year-old apparently healthy woman was diagnosed as a hamartoma with haemangiomatous structures and a large cyst, probably secondary to haemorrhage within the lesion. After reviewing the histological records of all the previously published cases of similar "haemorrhagic" non-inflammatory adrenal cysts, the aetiology of which has been considered unclear, we conclude that they too were probably hamartomas. We therefore propose that this type of adrenal cyst, the only of clinical importance, is aetiologically a hamartoma. These tumours often show super-imposed degenerative post-haemorrhagic changes.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
12/15. Massive hepatomegaly in a 6-week-old infant: is it neuroblastoma?neuroblastoma is described in a 6-week-old baby presenting with a rapidly enlarging liver. Initial ultrasound examination of the abdomen could not characterize the tumour but a second examination showed a cyst in the superior pole of the kidney which at autopsy was found to be due to adrenal haemorrhage. The role of prenatal and postnatal ultrasonography in the diagnosis of neuroblastoma is emphasized. This tumour is more common in white children in the more industrialized countries, but even in developing countries clinicians should remain alert to its myriad manifestations.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
13/15. Biochemical diagnosis of phaeochromocytoma: two instructive case reports.The biochemical features of two patients with phaeochromocytomas illustrate the inadvisability of depending on a single group of analytes for the diagnosis. The first case presented as a surgical emergency with retroperitoneal haemorrhage. Biochemical diagnosis was difficult since total 24 hour urinary free catecholamine excretion was within normal limits in two out of three samples, and only marginally raised in the third with an atypical preponderance of adrenaline. plasma catecholamine concentrations were also normal. But urinary excretion of the catecholamine metabolites, metadrenaline and 4-hydroxy-3-methoxy mandelic acid (HMMA), was consistently raised. In contrast, the second patient presenting with headache and labile hypertension showed normal metabolite excretion in the face of grossly increased free noradrenaline excretion and raised plasma noradrenaline concentrations. It is therefore recommend that, as well as urinary free catecholamines, one group of their main metabolites, the 3-methoxy amines (normetadrenaline and metadrenaline) or HMMA, should routinely be measured whenever a phaeochromocytoma is suspected.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
14/15. Case report: rupture and growth of adrenal myelolipoma in two patients.Two cases of pathologically confirmed adrenal myelolipoma are described in Chinese patients. The first patient presented with tumour rupture and perinephric haemorrhage. The second patient was operated on 18 months after the incidental discovery of the tumour, due to its large size and the interval growth.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
15/15. Phaeochromocytoma with central nervous system manifestations.A 35-year-old Samoan male presented with intermittent headaches and hypertensive episodes for several months. A subsequent left adrenal gland phaeochromocytoma was discovered and surgically excised. An MRI of his brain demonstrated periventricular, basal ganglia, and centrum semi-ovale infarction. We suggest that catecholamine excess and neuropeptide y may contribute to intracerebral haemorrhage and infarcts associated with phaeochromocytomas. Additionally, our surgical approach in removing the phaeochromocytoma is discussed.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
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