scholarly journals Experience of a Tertiary-Level Urology Center in Clinical Urological Events of Rare and Very Rare Incidence. V. Urological Tumors: 1. Adrenal Myelolipoma

2020 ◽  
Vol 14 (2) ◽  
pp. 85-91
Author(s):  
Rabea A. Gadelkareem ◽  
Ahmed M. Moeen ◽  
Mahmoud Khalil ◽  
Ahmed Reda ◽  
Mahmoud Farouk ◽  
...  
Keyword(s):  
Benign Tumor ◽  
Adrenal Tumor ◽  
Pathological Examination ◽  
Adrenal Tumors ◽  
Adrenal Myelolipoma ◽  
Promising Alternative ◽  
Alternative Approach ◽  
Laparoscopic Excision ◽  
Hospital Stay Duration ◽  
Characteristic Picture

Objectives: To present our center's experience in the management of adrenal myelolipoma in the context of shifting from the open to the laparoscopic adrenalectomy approach. Materials and Methods: A retrospective search of our center's records was done for reported cases of adrenal myelolipoma during the period July 2001-June 2016. All the cases with histopathologically-documented adrenal myelolipoma diagnosis were included. Relevant demographic and clinical variables were studied with a comparison between the open and laparoscopic approaches. Results: Of more than 82,000 urological surgeries, 238 adrenalectomies were done with only 22 cases of myelolipoma that had a mean age and body mass index of 52.4 ± 10.3 years and 30.23 kg/m2, respectively. The main clinical presentation was accidental discovery. The largest dimension of tumors varied from 6 to 16 cm. Computed tomography described a characteristic picture of hypodense heterogeneous adrenal tumors in all cases, while magnetic resonance imaging was indicated for malignancy suspicion in only 5 cases. Adrenal tumor markers were normal in all cases. Open and transperitoneal laparoscopic adrenalectomies were used in 14 and 8 cases, respectively. The latter approach was insignificantly advantageous in the need for blood transfusion, postoperative pain degree, need for analgesia, and hospital stay duration (p = 0.22). Histo-pathological examination revealed benign adipose tissue and myeloid cells and confirmed the diagnosis of adrenal myelolipoma in all cases. Conclusions: Adrenal myelolipoma is a rare non-functioning benign tumor. Laparoscopic excision seems to be a promising alternative approach to the traditional open adrenalectomy, even in the context of large tumors and obesity.

scholarly journals Adrenal Incidentaloma: Challenges in Diagnosing Adrenal Myelolipoma

2019 ◽  
Vol 7 ◽  
pp. 232470961987031 ◽  
Author(s):  
Sreedhar Adapa ◽  
Srikanth Naramala ◽  
Vijay Gayam ◽  
Frank Gavini ◽  
Hemant Dhingra ◽  
...  
Keyword(s):  
Adrenal Tumor ◽  
Fluid Overload ◽  
Elevated Serum ◽  
Adrenal Incidentaloma ◽  
Uncontrolled Hypertension ◽  
Adrenal Tumors ◽  
Functional Aspect ◽  
Hematopoietic Tissue ◽  
Norepinephrine Level ◽  
Adrenal Myelolipoma

Adrenal myelolipomas (AMLs) are rare benign adrenal tumors, containing adipose and hematopoietic tissue, a result of reticuloendothelial cell metaplasia. Incidence on autopsy has been reported from 0.08% to 0.4%. AMLs are generally considered nonsecretory. The functional aspect of adrenal incidentaloma should be evaluated. In this article, we report a case of a 40-year-old male, who presented with uncontrolled hypertension and renal failure, with imaging revealing an adrenal incidentaloma. He was started on dialysis for acute fluid overload, and workup for pheochromocytoma revealed an elevated serum norepinephrine level of 1181 pg/mL. Free metanephrine and normetanephrine levels were low when checked pre- and post-dialysis. Complete resection of the encapsulated right adrenal mass was performed. Pathology of the adrenal tumor demonstrates an 11.5 × 9.5 × 7.5 cm well-circumscribed, partially encapsulated proliferation of mature adipose tissue with admixed hemopoietic elements consistent with myelolipoma weighing 29.3 g. This case highlights the inclusion of a full metabolic workup for all adrenal incidentalomas, including AML.

scholarly journals Adrenal Myelolipoma Diagnosed in a 72-Year-Old Patient with Abdominal Pain

10.3823/2506 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Tiago Galan de Franca ◽  
Gabriela Ferreira Rocha ◽  
Sheyla Cristina De Souza Calixto
Keyword(s):  
Abdominal Pain ◽  
Private Hospital ◽  
Benign Tumor ◽  
Adrenal Tumor ◽  
Initial Symptom ◽  
Hematopoietic Tissue ◽  
Adrenal Myelolipoma ◽  
Diffuse Abdominal Pain ◽  
Difficult Diagnosis ◽  
Rare Benign Tumor

BACKGROUND: Adrenal myelolipoma is a rare benign tumor formed by hematopoietic tissue and mature adipose tissue. Usually is insidious and found occasionally on image exams, therefore is also called incidentaloma. Image studies and anatomopathological exam are important to define the diagnosis of adrenal myelolipoma. This study’s objective was to report the case of this rare adrenal tumor and its main diagnostic means. CASE: It was report case about a 72-year-old patient, whose initial symptom was diffuse abdominal pain, nausea and vomiting, diagnosed with adrenal myelolipoma after image studies even in the absence of laboratory abnormalities, and submitted at a private hospital at Belém-PA. CONCLUSIONS: The adrenal myelolipoma, due its usual asymptomatic characteristics or its no-specifics symptoms, requires a meticulous analysis concerning both diagnosis and treatment. Thus, our case report corroborates the importance of the image studies in front of an obscure and difficult diagnosis, especially the computed tomography, and anatomopathological evaluation, since they are essential to the best decision making and consequently a better prognosis of the patient.  

scholarly journals Adrenal myelolipoma: a case report

2021 ◽  
Vol 11 (3) ◽  
pp. 231-234
Author(s):  
Mohammad Sowkat Hossain ◽  
SM Mahbubul Alam ◽  
Sk Md Jaynul Islam ◽  
Shamoli Yasmin
Keyword(s):  
Benign Tumor ◽  
Adrenal Tumor ◽  
Clinical Presentation ◽  
Hormone Secretion ◽  
Final Diagnosis ◽  
Fatty Tissue ◽  
Adrenal Myelolipoma ◽  
Abdominal Symptoms ◽  
Adrenocortical Adenomas ◽  
Rare Benign Tumor

Myelolipoma is a relatively rare benign tumor of adrenal gland. Most cases are non-functioning and asymptomatic and usually discovered during various diagnostic-imaging procedures performed for other diseases of abdomen. Cases associated with excessive hormone secretion have been reported which may constitute adrenocortical adenomas with associated myelolipomatous components. Histopathological findings are very interesting and the tumor is composed of bone marrow elements with various amounts of fatty tissue. The fat component in myelolipoma can facilitate the diagnosis by radiological examination. Here, we report a case of adrenal myelolipoma and its clinical presentation and evaluation. In this case, initially the patient presented with nonspecific abdominal symptoms. Her adrenal tumor was found incidentally and the final diagnosis was proved by histopathology. BIRDEM Med J 2021; 11(3): 231-234

scholarly journals A Rare Entity of Benign Recurring Mesenchymal Tumor of the Female Urethra

2013 ◽  
Vol 2013 ◽  
pp. 1-2
Author(s):  
Onur Telli ◽  
Haşmet Sarıcı ◽  
Berat Cem Özgür ◽  
Cem Nedim Yücetürk ◽  
Mehmet Ali Karagöz
Keyword(s):  
Lower Urinary Tract ◽  
Soft Tissue Tumor ◽  
Benign Tumor ◽  
Pathological Examination ◽  
Rare Entity ◽  
Female Urethra ◽  
Mesenchymal Tumors ◽  
Urinary Tract Symptoms ◽  
Myxoid Matrix ◽  
Lower Urinary

This is a case report of a 51-year-old female patient with benign mesenchymal tumors of paraurethral region which caused lower urinary tract symptoms. The pathological examination of the lesion was reported as angiomyxoma which is a distinct soft tissue tumor characterized by the presence of prominent myxoid matrix and numerous thin-walled blood vessels. This tumor has a predilection for the trunk, head and neck, extremities, and genitalia. It is a benign tumor, and total excision is curative. Recurrence is rare except for aggressive angiomyxomas.

Adrenal Cortical Adenoma With Adrenalin-Type Neurosecretory Granules Clinically Mimicking a Pheochromocytoma

2002 ◽  
Vol 126 (12) ◽  
pp. 1530-1533 ◽  
Author(s):  
Tomislav Ivsic ◽  
Richard A. Komorowski ◽  
Gary S. Sudakoff ◽  
Stuart D. Wilson ◽  
Milton W. Datta
Keyword(s):  
Electron Microscopy ◽  
Clinical Outcome ◽  
Tumor Cells ◽  
Clinical Features ◽  
Adrenal Tumor ◽  
Histologic Examination ◽  
Adrenal Tumors ◽  
Neurosecretory Granules ◽  
Adrenal Cortical Adenoma ◽  
Pathologic Features

Abstract Adrenal tumors often present with clinical features that are specific and unique to their endocrine metabolism. When these features are in conflict with the pathologic appearance of the tumor, there can be great consternation for both the pathologist and the surgeon. In the case reported herein, an adrenalectomy was performed for clinical features of pheochromocytoma that on gross and histologic examination had the pathologic features of an adrenal cortical adenoma. Electron microscopy subsequently revealed that the tumor cells contained adrenalin-type granules, explaining the clinical outcome. It is crucial for both the surgeon and the surgical pathologist to be aware of this possibility when the clinical and pathologic features of an adrenal tumor are not congruent.

scholarly journals Virulence-Inhibiting Herbal Compound Falcarindiol Significantly Reduced Mortality in Mice Infected with Pseudomonas aeruginosa

Antibiotics ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 136 ◽  
Author(s):  
Pansong Zhang ◽  
Qiaolian Wu ◽  
Lin Chen ◽  
Kangmin Duan
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Type Iii Secretion ◽  
Pathogenic Bacteria ◽  
Secretion System ◽  
Chinese Herbs ◽  
Drug Candidate ◽  
Swarming Motility ◽  
Promising Alternative ◽  
Alternative Approach ◽  
Herbal Compound

Antipathogenic compounds that target the virulence of pathogenic bacteria rather than their viability offer a promising alternative approach to treat infectious diseases. Using extracts from 30 Chinese herbs that are known for treating symptoms resembling infections, we identified an active compound falcarindiol from Notopterygium incisum Ting ex H. T. Chang that showed potent inhibitory activities against Pseudomonas aeruginosa multiple virulence factors. Falcarindiol significantly repressed virulence-related genes, including the type III secretion system (T3SS); quorum sensing synthase genes lasIR and rhlIR; lasB; motility-related genes fliC and fliG; and phenazine synthesis genes phzA1 and phzA2. P. aeruginosa swarming motility and pyocyanin production were reduced significantly. In a burned mouse model, falcarindiol treatment significantly reduced the mortality in mice infected with P. aeruginosa, indicating that falcarindiol is a promising antipathogenic drug candidate for treating P. aeruginosa infections.

scholarly journals Progress in Synthesizing Analogues of Nitrogenase Metalloclusters for Catalytic Reduction of Nitrogen to Ammonia

Catalysts ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. 939
Author(s):  
Yang
Keyword(s):  
Energy Consumption ◽  
Catalytic Reduction ◽  
High Energy ◽  
Ambient Conditions ◽  
Promising Alternative ◽  
Fossil Energy ◽  
Alternative Approach ◽  
Increasing Demand ◽  
High Energy Consumption ◽  
Significant Opportunity

Ammonia (NH3) has played an essential role in meeting the increasing demand for food and the worldwide need for nitrogen (N2) fertilizer since 1913. Unfortunately, the traditional Haber–Bosch process for producing NH3 from N2 is a high energy-consumption process with approximately 1.9 metric tons of fossil CO2 being released per metric ton of NH3 produced. As a very challenging target, any ideal NH3 production process reducing fossil energy consumption and environmental pollution would be welcomed. Catalytic NH3 synthesis is an attractive and promising alternative approach. Therefore, developing efficient catalysts for synthesizing NH3 from N2 under ambient conditions would create a significant opportunity to directly provide nitrogenous fertilizers in agricultural fields as needed in a distributed manner. In this paper, the literature on alternative, available, and sustainable NH3 production processes in terms of the scientific aspects of the spatial structures of nitrogenase metalloclusters, the mechanism of reducing N2 to NH3 catalyzed by nitrogenase, the synthetic analogues of nitrogenase metalloclusters, and the opportunities for continued research are reviewed.

Adrenal Myelolipoma: Report of a Case and Review of the Literature

2006 ◽  
Vol 72 (7) ◽  
pp. 649-654 ◽  
Author(s):  
Vijaykumar G. Patel ◽  
Olufemi A. Babalola ◽  
James K. Fortson ◽  
William L. Weaver
Keyword(s):  
Computed Tomography ◽  
Benign Tumor ◽  
Incidental Finding ◽  
Symptomatic Relief ◽  
Retroperitoneal Hemorrhage ◽  
Adrenal Myelolipoma ◽  
Rare Benign Tumor ◽  
Hemopoietic Tissue ◽  
General Surgeons ◽  
Tomography Scan

Adrenal myelolipoma is a rare benign tumor composed of mature lipomatous and hemopoietic tissue. Although it is often discovered as an incidental finding on imaging of the abdomen for some other reason or at autopsy, adrenal myelolipoma has been reported to present with symptoms such as flank pain resulting from tumor bulk, necrosis, or spontaneous retroperitoneal hemorrhage. Myelolipomas are hormonally inactive but have also been reported to coexist with other hormonally active tumors of the adrenal gland. They are usually unilateral but may be bilateral and may also develop in extraadrenal sites like the retroperitoneum, thorax, and pelvis. We report a patient with symptomatic adrenal myelolipoma diagnosed on computed tomography scan and confirmed on computed tomography-guided biopsy. The patient underwent surgical resection for symptomatic relief. We also review the literature to evaluate the presentation and optimal management of this rare adrenal tumor that is not encountered by most general surgeons and therefore not well known to most surgeons.

scholarly journals An Interesting Cause of Hyperandrogenemic Hirsutism

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Murat Atmaca ◽  
İsmet Seven ◽  
Rıfkı Üçler ◽  
Murat Alay ◽  
Veysi Barut ◽  
...  
Keyword(s):  
Postmenopausal Woman ◽  
Aging Process ◽  
Adrenal Tumor ◽  
Clinical Signs ◽  
Serum Testosterone ◽  
Adrenal Tumors ◽  
Androgen Excess ◽  
Pelvic Mri ◽  
Abdomen Ct ◽  
Specific Source

Mild clinical signs of hyperandrogenism such as hirsutism may appear during the menopausal transition as part of the normal aging process, but the development of frank virilization suggests a specific source of androgen excess. We report a case of a 68-year-old woman with signs of virilization that had started 6 months before. Clinical analyses revealed high levels of serum testosterone for a postmenopausal woman. Pelvic MRI and abdomen CT showed no evidence of ovarian and adrenal tumor. Postmenopausal hyperandrogenism can be the result of numerous etiologies ranging from normal physiologic changes to ovarian or rarely adrenal tumors. Our patient was found to have iatrogenic hyperandrogenism. This condition is rarely reported cause of virilization.

scholarly journals Advances in adrenal tumors 2018

2018 ◽  
Vol 25 (7) ◽  
pp. R405-R420 ◽  
Author(s):  
J Crona ◽  
F Beuschlein ◽  
K Pacak ◽  
B Skogseid
Keyword(s):  
Clinical Trials ◽  
Translational Research ◽  
Adrenal Tumor ◽  
Clinical Care ◽  
Scientific Field ◽  
Adrenal Tumors ◽  
Recent Advances ◽  
Future Success ◽  
Tumor Research

This review aims to provide clinicians and researchers with a condensed update on the most important studies in the field during 2017. We present the academic output measured by active clinical trials and peer-reviewed published manuscripts. The most important and contributory manuscripts were summarized for each diagnostic entity, with a particular focus on manuscripts that describe translational research that have the potential to improve clinical care. Finally, we highlight the importance of collaborations in adrenal tumor research, which allowed for these recent advances and provide structures for future success in this scientific field.

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