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Possible Origin of Aldosteronoma from Adrenohepatic Fusion Resulting in Intrahepatic Tumor  [PDF]
Takumi Takeuchi, Takashi Inoue, Keiko Kanemoto, Kazuchika Hagiwara, Koji Mikami, Mami Hattori, Masayoshi Zaitsu, Akiko Tonooka, Toshimasa Uekusa, Susumu Uda
Open Journal of Urology (OJU) , 2013, DOI: 10.4236/oju.2013.36042
Abstract:

A 69-year-old woman was diagnosed with primary aldosteronism. An enhanced computed tomography (CT) scan before surgery indicated a right adrenal tumor outside the liver. Venous sampling tests revealed unilateral overproduction of aldosterone by the right adrenal gland. Separation of the right adrenal cortex from the liver parenchyma was impractical during a laparoscopic right adrenalectomy because of the solid attachment between the two. Therefore, the existence of adrenohepatic fusion was determined. An incision was made within the right adrenal gland, leaving completely the intrahepatic adrenal tissue on the inner side of the liver, because a partial hepatectomy was not preoperatively planned, and the patient was not informed of the consent before the surgery. Pathological examination did not reveal macro- or micro-adenomas in the resected right adrenal tissue. Aldosterone to renin ratio was as high as 1380 at 22 days following the surgery. Therefore, aldosteronoma originated from the adrenohepatic fusion that remained on the inner side of the liver was highly suspected. The patient’s blood pressure was well controlled, and she did not prefer hepatectomy to be further performed, and therefore, medical therapy was continued. When planning the type of surgery (laparoscopic or open) in these potentially confusing cases, it might be necessary to consider a possibility of the unexpected intraoperative diagnosis and the immediate measures to be performed based on the diagnosis.

A Rare Tumor in a Rare Location: Ganglioneuroma  [PDF]
Faisal El Mouhafid, Abderrahmane Hajoujji, Ait Ali Abdelmounaime, Aziz Zentar
Surgical Science (SS) , 2022, DOI: 10.4236/ss.2022.136037
Abstract: Ganglioneuroma is a rare benign tumor Neuronagliomas of the adrenal gland are a rare pathology. Therefore, this case will be of interest to urologists, surgeons, oncologists, and pathologists. Located in the adrenal gland (20%), along the sympathetic chain, and particularly in the posterior mediastinum (40%) and the retroperitoneum (30%). Ganglioneuroma poses a positive diagnostic and therapeutic problem. We report the case of a patient aged 48 admitted for pain in the right hypochondrium. He had no significant past medical or surgical history. On a physical examination, there were no noticeable findings except for mild tenderness and a mass on palpation. He underwent abdominal CT, which showed a relatively homogenous right adrenal tumor measuring. Endocrine work-up including urine catecholamine and cortisol levels was normal. Due to the tumor size and with consideration of the differential diagnosis of a malignant lesion, we elected to operate on the patient. Right adrenalectomy was performed, with no related complications. The final histopathologic report revealed adrenal ganglioneuroma. Although benign, the ganglioneuroma can present malignant aspects, in particular, CT scans and biological that can mislead the clinician, so histology remains the examination of choice for making the diagnosis.
Corticosurrenaloma: About a Pediatric Case  [PDF]
Thierry Mukenge Wa Mukengeshay, Fatoumata Binta Balde, Zineb Benmassaoud, Priscilla Kinsala, Othmane Allaoui, Abdelhalim Mahmoudi, Khalid Khattala, Sara Benmilloud, Youssef Bouabdallah
Open Journal of Pediatrics (OJPed) , 2022, DOI: 10.4236/ojped.2022.122048
Abstract: Introduction: This study aims to describe the outcome of adrenocortical cancer in children through observation. Observation: A 10-year-old girl with no previous pathological history. She presented headaches and severe hypertension with clinical and biological signs of hyperandrogenism for 6 months. An abdominal CT scan showed an encapsulated left adrenal mass without local or regional invasion or secondary location. A pheochromocytoma or adrenal neuroblastoma was first suspected. The blood pressure was stable at 130/65 mmHg under antihypertensive drugs. She underwent a complete tumor resection without any intraoperative incident. The pathologic study confirmed the adrenocortical carcinoma scored Weiss 7. The severe high blood pressure reappeared 2-year later despite antihypertensive drugs. The thoracic abdominal and pelvic CT scan showed a locally advanced tumor recurrence in the left adrenal gland with parenchymal nodes in the lungs and liver. The outcome was fatal despite medical and surgical management. Conclusion: Adrenocortical cancer is a rare tumor. It is important to
Virilizing Ovarian Leydig Cell Tumor with Multiple Non-Functional Endocrine Neoplasias: A Case Report  [PDF]
Yining Xie, Shan Zhong, Qijing Zhou, Zhiheng Huang, Xiaoxiao Song, Xiaohong Xu
International Journal of Clinical Medicine (IJCM) , 2019, DOI: 10.4236/ijcm.2019.104023
Abstract: Ovarian Leydig cell tumor, a sub-type of ovarian steroid cell tumor, accounts for less than 0.1% of all ovarian tumors. It can affect women of any age group but is most common in postmenopausal women. We here report a case of virilizing ovarian Leydig cell tumor with multiple non-functional endocrine neoplasias (pituitary and adrenal adenomas) in a 48-year-old woman. She first presented with sub-abdominal pain and hirsutism since menopause three years ago. Subsequently, she had slight facial acne, voice deepening, breast atrophy, and a prominent Adam’s apple. Her hormone profile showed an elevated level of testosterone, high free androgen index, low levels of luteinizing hormone and follicle stimulating hormone, and normal levels of random cortisol, androstenedione, 17-hydroxyprogesterone and dehydroepiandrosterone sulfate. A pelvic enhanced magnetic resonance imaging (MRI) scan showed nodules in the right ovary, and a pituitary enhanced MRI revealed a microadenoma. An enhanced computerized tomography scan of the adrenal gland revealed left adrenal nodules, possibly adenomas. After a right cystectomy and right fallopian tube resection, her testosterone level declined to 0.38 nmol/L and the symptoms associated with hyperandrogenism improved. This is a rare case of virilizing ovarian Leydig cell tumor with multiple non-functional endocrine neoplasias. We believe our findings will be helpful in the clinical diagnosis and treatment of hyperandrogenism.
Laparoscopic adrenalectomy for adrenal myelolipoma
Castillo,Octavio A.; Vitagliano,Gonzalo; Cortes,Oscar; Sánchez-Salas,Rafael; Arellano,Leonardo;
Archivos Espa？oles de Urología (Ed. impresa) , 2007, DOI: 10.4321/S0004-06142007000200022
Abstract: objetive: to evaluate the results of laparoscopic adrenalectomy for adrenal myelolipoma in a single center. methods: between november 1999 and february 2006, 226 laparoscopic adrenalectomies were performed at our institution. 19 specimens corresponded with adrenal myelolipomas (8%). mean patient age was 53.8 years (range 35 to 75) with male-to-female ratio 2:1. clinical data was prospectively collected. patient characteristics, lesion size evaluated by ct scan or mri, surgical technique, operative time, operative blood loss, complications, conversion to open surgery and hospital stay were reviewed. results: nineteen adrenal myelolipomas were laparoscopically treated in eighteen patients. 16 lesions were located on the right adrenal gland (84%). mean surgical time was 84.7 minutes (range 45 to 150). average bleeding was 25.8 ml (range 0 to 300). only one patient required a blood transfusion. there were no intraoperative complications or conversions to open surgery. average hospital stay was 2.1 days (range 1 to 4); no complications were registered during the immediate postoperative period. pathology reports confirmed all specimens as myelolipomas. mean maximum tumor diameter was 8.6 cm (range 4.5 to 14). conclusions: adrenal myelolipoma is an infrequent, benign entity which can occasionally become symptomatic due to spontaneous hemorrhage. typical radiographic presentation permits conservative management in asymptomatic small masses. in cases where surgical treatment is advocated, laparoscopic surgery is a safe and feasible technique with reasonable operating time as well as limited blood loss, hospital stay and convalescence.
Mielolipoma de glándula suprarenal: Reporte de un caso
Benítez,G; Obregón,F; García,E; González,J; Rodríguez,O; LaForgia,G; Scorzza,R;
Revista de la Facultad de Medicina , 2005,
Abstract: objective: describe clinical aspects, imagenology and treatment of this unusual pathology. ambient: servicio de cirugía iii. hospital universitario de caracas. methods: a clinical case report and literature review. results: myelolipoma was defined by oberling in 1929 to nominate a benign variety of tumors made for mature fat and hematopoyetic tissue from adrenal stroma(1). autopsy incidence are between 0,3 and 0,4%(2), increase in patients with obesity(2,3) and more frequently between 4th and 6th decades of life(4). diagnostic test include magnetic resonance that show fatty areas with t1 amplify intensity and t2 moderate hyperdensity(5). recommended treatment when tumors are bigger than 5 cm. is surgical(6).
Pseudoquiste adrenal: Aportación de un nuevo caso y revisión de la literatura
Sáenz Medina,J.; Esteban Peris,A.; Linares Quevedo,A.I.; Vallejo Herrador,J.; Castillón Vela,I.; Páez Borda,A.;
Actas Urológicas Espa？olas , 2006, DOI: 10.4321/S0210-48062006000400013
Abstract: adrenal pseudocyst is the commonest type of benign lesions of adrenal gland althought is a very rare entity. most of them are found as "incidentalomas" during imaging studies. a case of a patient with a left non-functioning and asymptomatic adrenal pseudocyst is reported. the diagnostic and therapeutic options are discussed and the literature is reviewed.
Mielolipoma de glándula suprarenal: Reporte de un caso
G Benítez,F Obregón,E García,J González
Revista de la Facultad de Medicina , 2005,
Abstract: Objetivo: Describir la clínica, imagenología y el tratamiento de esta patología poco frecuente. Ambiente: Servicio de Cirugía III. Hospital Universitario de Caracas. Método: Reporte de un caso clínico y revisión de la literatura. Resultados: El término mielolipoma suprarrenal fue acu ado por Oberling en 1929 para denominar a una variedad de tumores benignos formados por tejido adiposo maduro y tejido mieloide hematopoyético originados en el estroma suprarrenal(1). Su incidencia en autopsias oscila entre el 0,3 y el 0,4 %(2), la misma aumenta en los pacientes obesos(2,3) y es más frecuente en la 4a a 6a década de la vida(4). Dentro de los estudios diagnósticos está la resonancia magnética en donde las áreas lipomatosas muestran intensidad aumentada en T1 y moderada hiperdensidad en T2(5). El tratamiento recomendado cuando son mayores de 5 cm. es quirúrgico(6). Objective: Describe clinical aspects, imagenology and treatment of this unusual pathology. Ambient: Servicio de Cirugía III. Hospital Universitario de Caracas. Methods: A clinical case report and literature review. Results: Myelolipoma was defined by Oberling in 1929 to nominate a benign variety of tumors made for mature fat and hematopoyetic tissue from adrenal stroma(1). Autopsy incidence are between 0,3 and 0,4%(2), increase in patients with obesity(2,3) and more frequently between 4th and 6th decades of life(4). Diagnostic test include magnetic resonance that show fatty areas with T1 amplify intensity and T2 moderate hyperdensity(5). Recommended treatment when tumors are bigger than 5 cm. is surgical(6).
Mielolipoma suprarrenal derecho gigante
Castillo Lario,María Carmen; Carro Alonso,Beatriz; Gimeno Peribá？ez,María José; Freile García,Emilio; Villavieja Atance,José Lucio;
Archivos Espa？oles de Urología (Ed. impresa) , 2006, DOI: 10.4321/S0004-06142006000900012
Abstract: objective: adrenal myelolipoma is a rare benign tumor, well limited, variable in size, composed of fatty and hematopoietic tissues, the finding of which is usually incidental. if they reach a big size they may produce the feeling of abdominal mass, pain, neighbour organs compression and acute intratumoral or retroperitoneal hemorrhage. methods: we report the case of a 57-year-old male admitted to the hospital with acute abdominal pain. ct scan with iv contrast and adrenal biopsy were performed. results: radiological findings: 9 x 10 cm right adrenal mass, well defined, hypodense, with a small calcification in its posterior area. pathologic findings: benign tumor, encapsulated, with a mixture of mature fatty tissue and hematopoietic cells. conclusions: the presence of fat within an adrenal mass is essential for the diagnosis. differential diagnosis should be done with all adrenal tumors with a fat component. when no radiological diagnosis is made, pathologic confirmation is necessary.
Mielolipoma adrenal bilateral ligado a hipotiroidismo primario
González Rivero,Levi; Turcios Tristá,Silvia Elena; León Chiong,Lino; Jequín Savariego,Esther; Domínguez Pacheco,Noraika;
Revista Cubana de Endocrinolog？-a , 2010,
Abstract: the adrenal myelolipomas are benign tumors, non-functioning and infrequent, generally of incidental diagnosis which by chance provoke local symptoms. after a review of published previous literature it was possible to describe of a clinical case of bilateral adrenal myelolipoma coexisting with a primary hypothyroidism with a relation not reported until now. such tumoral masses were diagnosed in a woman aged 66 with recurrent abdominal pain and hypothyroidism and hypercholesterolemia who undergoes successfully a exeresis of the bigger lesion. a diagnostic-therapeutic treatment was proposed for this type of tumors.
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