scholarly journals A Case of Retroperitoneal Ganglioneuroma Accidentally Discovered by Laparoscopic Right Adrenalectomy

2020 ◽  
Vol 13 (2) ◽  
pp. 764-767
Author(s):  
Shunsuke Nomura ◽  
Takashi Kawahara ◽  
Tappei Takeshima ◽  
Takahiro Mitomi ◽  
Daiji Takamoto ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Rare Case ◽  
Adrenal Tumor ◽  
Adrenal Adenoma ◽  
Pathological Diagnosis ◽  
Blood Sampling ◽  
Primary Hyperaldosteronism ◽  
Adrenal Vein ◽  
Small Nodule

A 65-year-old man was referred to our hospital for his right adrenal adenoma. Adrenal vein blood sampling revealed primary hyperaldosteronism, and he was referred to our department for surgical resection of his right adenoma. During the operation, a small nodule was discovered in addition to the adrenal tumor. The pathological diagnosis of this nodule was ganglioneuroma. We herein report a rare case of ganglioneuroma incidentally discovered by laparoscopic right adrenalectomy.

scholarly journals Uterine Tumor Resembling Ovarian Sex Cord Tumor: Clinicopathological Characteristics of a Rare Case

2020 ◽  
Vol 13 (2) ◽  
pp. 807-812
Author(s):  
Chu Van Nguyen ◽  
Huyen Thi Phung ◽  
Luan Thi Dao ◽  
Dang Hong Hai Ta ◽  
Minh Ngoc Tran
Keyword(s):  
Surgical Resection ◽  
Rare Case ◽  
Clinicopathological Characteristics ◽  
Pathological Diagnosis ◽  
Polypoid Mass ◽  
Significant Information ◽  
Uterine Tumor

Uterine tumor resembling ovarian sex cord tumor (UTROSCT) is a rare indolent stromal neoplasm of unclear histogenesis with a distinct histopathological entity. Immunophenotypes of sex cord positivity are the most significant information to confirm the diagnosis. We present the case of a 61-year-old female with a polypoid mass in the uterus which was successfully removed by surgical resection as hysterectomy. The pathological diagnosis was UTROSCT, which was characterized microscopically by sex cord images and immunohistochemical features of calretinin, CD99, and WT1 positivity.

scholarly journals SUN-202 Is a “Failed” Adrenal Venous Sampling Useful for Surgical Decision Making in Primary Hyperaldosteronism?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Rania El Mais ◽  
Runa Acharya
Keyword(s):  
Adrenal Adenoma ◽  
Plasma Aldosterone ◽  
Primary Hyperaldosteronism ◽  
Adrenal Vein ◽  
Adrenal Venous Sampling ◽  
Uncontrolled Hypertension ◽  
Venous Sampling ◽  
Plasma Aldosterone Concentration ◽  
Salt Loading ◽  
The Right

Abstract Background Adrenal venous sampling (AVS) is important in differentiating unilateral vs bilateral primary hyperaldosteronism. A limitation is the difficult cannulation of the right adrenal vein (RAV). A study in 2016(1) investigated the usefulness of AVS with failed right sided cannulation. The investigators calculated the ratios of plasma aldosterone and cortisol in the periphery (IVC) and in the left adrenal vein (LAV), then corrected the aldosterone/cortisol ratio of the LAV for that of the IVC with the following equation: LAV/ IVC = [aldosterone in LAV/cortisol in LAV] / [aldosterone in IVC/ cortisol in IVC]. A LAV/IVC ratio ≥5.5 and ≤0.5 predicted unilateral aldosterone hypersecretion on left and right side respectively with a 100% specificity and positive predictive value. Clinical case We present a case of a 51-year-old patient with primary hyperaldosteronism and a failed right sided cannulation. Patient presented with uncontrolled hypertension of 10 years and hypokalemia. His blood pressure (BP) was 190/100 on amlodipine, lisinopril, atenolol, hydralazine and spironolactone. Screening labs obtained off spironolactone and atenolol showed: Aldosterone 18.5ng/dl(0-30), renin 0.215ng/ml(0.167-5.738), plasma aldosterone concentration (PAC)/ plasma renin concentration (PRC) 86. CT abdomen showed a 1.2cmX1cm left adrenal adenoma. A 24-hour urine collection without salt loading showed an aldosterone of 43.46 microg/L (0-19). He underwent an AVS with a failed RAV cannulation with the following results: IVC: cortisol=17.2 microg/dl, aldosterone= 8.9ng/dl, aldosterone/cortisol= 0.52 LAV: cortisol=420, aldosterone=2860, aldosterone/cortisol=6.8. Partial left adrenalectomy was performed. Pathology showed a benign adenoma. Although his BP initially improved, over several weeks, his BP was high again, and he had a recurrence of hypokalemia. A repeat PAC/PRC of 80 confirmed persistent hyperaldosteronism. He refused further interventions. Eplerenone was added resulting in BP control. Conclusion Based on the above study, his LAV/IVC of 13 predicts the source to be the left adrenal gland. However, this ratio did not apply in our patient and should be utilized carefully. References: 1.Pasternak JD, Epelboym I, Seiser N, Wingo M, Herman M, Cowan V, et al. Diagnostic utility of data from adrenal venous sampling for primary aldosteronism despite failed cannulation of the right adrenal vein. Surgery. 2016;159(1):267-73.

43: The Utility of Adrenal Vein Sampling in Primary Hyperaldosteronism

2007 ◽  
Vol 177 (4S) ◽  
pp. 15-16
Author(s):  
Christopher H. Hawkins ◽  
Chandru P. Sundaram ◽  
Amy R. Qi ◽  
Matthew S. Johnson
Keyword(s):  
Primary Hyperaldosteronism ◽  
Adrenal Vein ◽  
Adrenal Vein Sampling

Abstract #110: Hemorrhagic Subdiaphragmatic Bronchogenic Cyst Mimicking an Adrenal Tumor: a Rare Case

2015 ◽  
Vol 21 ◽  
pp. 6
Author(s):  
Roy Guinto ◽  
Michele Ledoux ◽  
Alicia Williams ◽  
Anthony Mark
Keyword(s):  
Rare Case ◽  
Adrenal Tumor ◽  
Bronchogenic Cyst

A rare case of primary hyperaldosteronism associated with chronic kidney disease-difficulties in diagnosis and treatment

2019 ◽  
Author(s):  
Letiţia Leuştean ◽  
Ginuţa Marcela Bălineanu ◽  
Cosmina Rimbu ◽  
Anamaria Hrişcă ◽  
Voroneanu Elena Luminiţa ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Rare Case ◽  
Primary Hyperaldosteronism ◽  
Diagnosis And Treatment

scholarly journals Isolated thoracic intramedullary Erdheim-Chester disease presenting with paraplegia: a case report and literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ikchan Jeon ◽  
Joon Hyuk Choi
Keyword(s):  
Surgical Resection ◽  
Fdg Pet ◽  
Rare Case ◽  
Systemic Disease ◽  
Mass Lesion ◽  
Erdheim Chester Disease ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Erdheim Chester ◽  
Chester Disease

Abstract Background Erdheim-Chester disease (ECD) is a rare, idiopathic, systemic non-Langerhans cell histiocytosis involving long bone and visceral organs. Central nervous system (CNS) involvement is uncommon and most cases develop as a part of systemic disease. We present a rare case of variant ECD as an isolated intramedullary tumor. Case presentation A 75-year-old female patient with a medical history of diabetes and hypertension presented with sudden-onset flaccid paraparesis for 1 day. Neurological examination revealed grade 2–3 weakness in both legs, decreased deep tendon reflex, loss of anal tone, and numbness below T4. Leg weakness deteriorated to G1 before surgery. Preoperative magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) showed an intramedullary mass lesion at T2-T4 with no systemic lesion, which was heterogeneous enhancement pattern with cord swelling and edema from C7 to T6. Gross total removal was achieved for the white-gray-colored and soft-natured intramedullary mass lesion with an ill-defined boundary. Histological finding revealed benign histiocytic proliferation with foamy histiocytes and uniform nuclei. We concluded it as an isolated intramedullary ECD. The patient showed self-standing and walkable at 18-month with no evidence of recurrence and new lesion on spine MRI and whole-body FDG-PET/CT until sudden occurrence of unknown originated thoracic cord infarction. Conclusions We experienced an extremely rare case of isolated intramedullary ECD, which was controlled by surgical resection with no adjuvant therapy. Histological examination is the most important for final diagnosis, and careful serial follow-up after surgical resection is required to identify the recurrence and progression to systemic disease.

scholarly journals A Rare Case of Pancreatic Endometriosis Masquerading as Pancreatic Mucinous Neoplasm

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Barton Huang ◽  
Annie Mooser ◽  
Danielle Carpenter ◽  
Grace Montenegro ◽  
Carrie Luu
Keyword(s):  
Distal Pancreatectomy ◽  
Female Patient ◽  
Surgical Resection ◽  
Rare Case ◽  
Cystic Lesions ◽  
Common Condition ◽  
Mucinous Neoplasm ◽  
Endometriotic Cyst

Endometriosis is a relatively common condition among women, and pancreatic endometriosis has been reported on rare occasions. Such pancreatic lesions are difficult to diagnose and distinguish from other cystic lesions of the pancreas preoperatively. This report describes a case of pancreatic endometriosis in a 51-year-old female patient. Imaging demonstrated an enlarging cyst with findings concerning for a mucinous neoplasm. The patient underwent robotic distal pancreatectomy and splenectomy. Histopathology revealed an endometriotic cyst. Pancreatic endometriosis can be difficult to distinguish from other lesions of the pancreas. Surgical resection should be undertaken in cases where malignancy is suspected.

FORMATION OF STEROID HORMONES IN THE ADRENAL ADENOMA AND ADJACENT ADRENAL TISSUE OF A PATIENT WITH PRIMARY ALDOSTERONISM

1963 ◽  
Vol 41 (1) ◽  
pp. 1955-1959
Author(s):  
Elizabeth MacArthur ◽  
V. J. O'Donnell
Keyword(s):  
Adrenal Gland ◽  
Steroid Hormones ◽  
Primary Aldosteronism ◽  
Incubation Medium ◽  
Adrenal Adenoma ◽  
Adrenal Vein ◽  
Adrenal Tissue

The in vitro steroidogenic capacity of an adrenal adenoma and adjacent adrenal tissue of a patient with primary aldosteronism was studied. The adenoma slices elaborated into the incubation medium 7.07 μg/g tissue of cortisol (78.2%), corticosterone (7.6%), and aldosterone (14.2%), while the slices of adjacent adrenal gland released 19.88 μg/g tissue of cortisol (79.1%), corticosterone (14.9%), 11β-hydroxyandrostenedione (3.9%), androstenedione (2.1%), and a trace of aldosterone. The steroid content of the adenoma and the adrenal slices after incubation was 4.22 and 3.19 μg/g tissue respectively. From the former, cortisol (51.1%), corticosterone (36.6%), and progesterone (12.4%) were isolated and from the latter cortisol (13.2%), corticosterone (56.1%), progesterone (17.2%), and androstenedione (13.5%). A sample of adrenal vein blood obtained prior to adrenalectomy exhibited a cortisol/corticosterone ratio of 2.45.

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