Cases reported "Carcinoma"

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1/13. Adrenal cancer with hypertension but low plasma renin and aldosterone.

    patients with malignant lesions of the adrenal gland may present with a syndrome of excess mineralocorticoids. Both primary hyperaldosteronism and excess mineralocorticoids other than aldosterone resulting from adrenal carcinoma have rarely been reported. In most patients with adrenal tumors secreting mineralocorticoids other than aldosterone, distant metastasis had already occurred at the time of diagnosis and the prognosis was poor. We present a rare case of adrenal cancer with hypertension in a patient with low plasma renin activity and a low plasma aldosterone concentration. The patient's blood pressure returned to normal after removal of the tumor. The patient is still alive and without recurrence 6 years after surgery. This case illustrates the value of thorough evaluation of hypertension and prompt surgical treatment for patients with adrenal cancer.
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ranking = 1
keywords = hyperaldosteronism, aldosteronism
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2/13. adrenocortical carcinoma manifesting pure primary aldosteronism: a case report and analysis of steroidogenic enzymes.

    adrenocortical carcinoma manifesting pure hyperaldosteronism is extremely rare. We report here a 61-year-old woman with biochemically proven primary aldosteronism due to right adrenocortical carcinoma. Computed tomographic scan showed 4.5x5.3 cm lobulated mass with tiny calcification, while there was no significant uptake of 131I-iodomethyl norcholesterol in the tumor. Immunohistochemical analysis demonstrated expression of steroidogenic enzymes in the tumor tissue: P-450scc, P-45c21, 3beta-hydroxysteroid dehydrogenase, P450(17alpha), and P-450(11beta). In addition, we could demonstrate mRNA expression of aldosterone synthase (P-450aldo:CYP11B2) in the tumor by specific ribonuclease protection assay. This is the first report of a case of primary aldosteronism due to adrenocortical carcinoma, in which expression of all sets of steroidogenic enzymes required for aldosterone synthesis was proven.
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ranking = 3.5006106836338
keywords = hyperaldosteronism, aldosteronism
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3/13. Primary aldosteronism and malignant adrenocortical neoplasia.

    Our experience indicates that although adrenal carcinoma is not a common cause of primary aldosteronism, 4 to 5% of patients in a single large series may have a malignant adrenocortical tumor. The magnitude of the hypokalemia and the hyperaldosteronuria tends to be greater in patients with malignant tumors, but these patients cannot be clearly separated from those with benign tumors or hyperplasia on this basis. patients who have malignant tumors may have no chemical evidence of adrenocortical dysfunction other than excessive aldosterone secretion. Finally, a good response to spironolactone for months does not exclude adrenal carcinoma as the cause of primary aldosteronism.
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ranking = 2.5006106836338
keywords = aldosteronism
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4/13. Isolated primary aldosteronism in a patient with adrenal carcinoma and XY/XXY mosaic Klinefelter's syndrome.

    Although breast cancer, germ cell tumors and other neoplasms are known to occur in patients with Klinefelter's syndrome, adrenal carcinoma has not yet been reported in such patients. We describe a rare case of severe primary aldosteronism as the unique manifestation of a large adrenocortical carcinoma in a patient with Klinefelter's syndrome. Complete biological and hormonal evaluation was performed. Surgical treatment was successful and the patient remained asymptomatic with normal biological and hormonal values after 1 year of followup.
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ranking = 2.0838422363615
keywords = aldosteronism
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5/13. adrenocortical carcinoma presenting as primary aldosteronism in a young man.

    A young Polynesian man presented with severe hypertension complicated by an intracerebral hemorrhage. The hypertension was found to be secondary to hyperaldosteronism from a well differentiated adrenocortical carcinoma. Surgical removal of the tumor has resulted in a near normal blood pressure with no evidence of tumour recurrence of hyperaldosteronism after one year.
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ranking = 3.6670737890892
keywords = hyperaldosteronism, aldosteronism
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6/13. Isolated clinical syndrome of primary aldosteronism in four patients with adrenocortical carcinoma.

    adrenocortical carcinoma is a rare disorder that can be revealed by an isolated syndrome of mineralocorticoid excess. In a retrospective study of 137 patients referred to our hypertension clinic in the past 10 years for primary aldosteronism, four cases of adrenocortical carcinoma were identified. The clinical presentation of these patients was similar to that of patients with Conn's adenoma, but preoperatively, malignant tumoral primary aldosteronism was suspected because of profound hypokalemia, marked elevation in plasma aldosterone levels, and enlarged size and weight of an heterogenous adrenal tumor with internal calcifications. Malignancy was confirmed by the histologic features. No prognostic criteria could be established and two patients died despite specific surgery, which was performed in all cases. More recent developments in the use of mitotane led to the addition of adrenocorticolytic therapy in the remaining two patients, who are still alive at the time of this report.
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ranking = 2.5006106836338
keywords = aldosteronism
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7/13. Carcinoma of the adrenal cortex causing primary hyperaldosteronism. A case report and review of the literature.

    A male patient presenting with primary hyperaldosteronism after a three-year delay, was found to have an aldosterone producing adrenocortical carcinoma. Evidence is presented that aldosterone was the only steroid produced in excess. Only six other patients with adrenocortical carcinoma and isolated primary hyperaldosteronism could be traced in the literature. The relation between histology and endocrine functions of the tumor cells is discussed.
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ranking = 6
keywords = hyperaldosteronism, aldosteronism
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8/13. Adrenal cortical carcinoma: an unusual cause of hyperaldosteronism.

    Although secondary hyperaldosteronism due to renal vein thrombosis may occur as a result of renal cell carcinoma or adrenal cortical carcinoma, primary hyperaldosteronism is rarely associated with the latter. This paper describes a patient with adrenal cortical carcinoma who presented with the clinical features of primary hyperaldosteronism 1 year after hypertension had been diagnosed; intravenous pyelography had not been done then. drug therapy was ineffective, and the patient died 10 weeks after presentation.
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ranking = 7
keywords = hyperaldosteronism, aldosteronism
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9/13. Pure primary hyperaldosteronism due to adrenal cortical carcinoma.

    A 47-year-old woman is described who had pure primary hyperaldosteronism due to an adrenal cortical carcinoma. This may represent the first such case in which modern laboratory tests allowed specific diagnosis and exclusion of hypersecretion of other adrenal steroids, and also the first reported case in which modern localizing procedures have been utilized. Other interesting facets of the case include calcification of the tumor, visualization with 131l iodomethylnorcholesterol , metaplastic histologic changes, and coexistent bilateral renal artery fibromuscular disease.
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ranking = 5
keywords = hyperaldosteronism, aldosteronism
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10/13. Primary aldosteronism due to adrenal cortical carcinoma.

    We report a rare case of primary aldosteronism due to adrenal cortical carcinoma. Endocrinological data showed an isolated excess of aldosterone production without any associated increase in other steroids. Adrenal scintigraphy, which has not been described in cases of primary aldosteronism due to adrenal cortical carcinoma, revealed an increased uptake of the radionuclide into the affected adrenal gland without suppression in the contralateral gland.
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ranking = 2.5006106836338
keywords = aldosteronism
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