OBJECTIVE: The purpose of this article is to improve the understanding of complications of pleomorphic adenocarcinoma, and the possibility of complicated with dermatomyositis. In order to explore whether there is a certain relationship between the two diseases. METHOD: Reported one patient in our hospital with the diagnosis of pleomorphic adenocarcinoma complicated dermatomyositis, and clarified the diagnosis and treatment of these two diseases during hospitalization. Reviewed the latest clinical literature relevant to pleomorphic adenocarcinoma and dermatomyositis. RESULT: The patients underwent superficial parotidectomy treatment. The postoperation pathologic and immunohistochemical examination confirmed the diagnosis of pleomorphic adenocarcinoma. Dermatomyositis improved better after the operation. CONCLUSION Pleomorphic adenocarcinoma has the possibility of complicated with dermatomyositis which may misdiagnosis in clinical practice. Summarize the latest diagnosis progress of pleomorphic adenocarcinoma and the surgical treatment of the tumor. Also discuss the standards of clinical diagnosis and treatment of dermatomyositis. Analysis there may be a relationship between the two diseases on autoimmune mechanism.
Adenoma, Pleomorphic ; complications ; surgery ; Aged ; Dermatomyositis ; complications ; Humans ; Male

A 39-yr-old woman, who had been treated for Behcet's disease for 4 yr, was admitted for further investigation of recently identified hypokalemia and hypertension. Suppressed plasma renin activity with elevated plasma aldosterone concentration and an anomalous postural decrease in plasma aldosterone were observed. An abdominal CT scan revealed a right adrenal mass. The patient was diagnosed with Conn's syndrome. The association of Conn's syndrome with Behcet's disease was thought to be coincidental. To our knowledge, this is the first case of Conn's syndrome associated with Behcet's disease.
Adenoma/complications ; Adenoma/radiography ; Adenoma/secretion ; Adenoma/surgery ; Adrenal Cortex Neoplasms/complications ; Adrenal Cortex Neoplasms/radiography ; Adrenal Cortex Neoplasms/secretion ; Adrenal Cortex Neoplasms/surgery ; Adrenalectomy ; Adult ; Aldosterone/secretion ; Behcet Syndrome/complications* ; Female ; Human ; Hyperaldosteronism/blood ; Hyperaldosteronism/complications*

Humans ; Aldosterone ; Hyperaldosteronism/diagnosis* ; Adrenal Gland Neoplasms/complications* ; Adenoma/diagnosis*

Adrenal Cortex Neoplasms ; complications ; Adrenal Gland Neoplasms ; complications ; Adrenal Glands ; pathology ; Adrenocortical Adenoma ; complications ; Humans ; Pheochromocytoma ; complications

OBJECTIVE: To investigate the coagulation function indicators and identify influence factors of hypercoagulability in patients with adrenocorticotropic hormone (ACTH) independent Cushing syndrome (CS). METHODS: In our retrospective study, the electronic medical records system of Peking University First Hospital was searched for the patients diagnosed with ACTH independent CS on discharge from January 2014 to June 2019. Nonfunctional adrenal adenoma patients were chosen as control group and matched 1 ∶1 by body mass index (BMI), gender, and discharge date. Clinical features and coagulation function indicators were compared between the two groups. RESULTS: In the study, 171 patients were included in each group. Compared with control group, activated partial thromboplastin time (APTT), and prothrombin time (PT) in ACTH independent CS group were significantly lower [(29.22±3.39) s vs. (31.86±3.63) s, P < 0.001; (29.22±3.39) s vs. (31.86±3.63) s, P < 0.001], and both D-dimer and fibrin degradation products (FDP) levels were significantly higher (P < 0.05). Percentage of APTT levels under the lower limit of reference range in the CS patients was significantly higher than that in nonfunctional group (21.6% vs. 3.5%, P < 0.001). Percentage of D-dimer levels over the upper limit of reference range in the CS patients was significantly higher than that in nonfunctional group (13.5% vs. 6.6%, P=0.041). There were three patients with deep venous thrombosis and one patient with pulmonary embolism in CS group, however none was in control group. The area under curve (AUC) of serum cortisol rhythm (8:00, 16:00 and 24:00) levels was negatively associated with the levels of PT (r=-0.315, P < 0.001) and APTT (r=-0.410, P < 0.001), and positively associated with FDP (r=0.303, P < 0.001) and D-dimer levels (r=0.258, P < 0.001). There were no differences in coagulation function indicators among different histopathologic subgroups (adrenocortical adenoma, adrenocortical hyperplasia, oncocytic adenoma, adrenocortical carcinoma). With Logistic regression analysis, the AUC of cortisol and glycosylated hemoglobin A1c (HbA1c) levels were independent risk factors for hypercoagulability in the ACTH independent CS patients (P < 0.05). CONCLUSION ACTH independent CS patients were more likely in hypercoagulable state compared with nonfunctional adrenal adenoma, especially in ACTH independent CS patients with higher levels of cortisol AUC and HbA1c. These patients should be paid attention to for the hypercoagulability and thrombosis risk.
Humans ; Cushing Syndrome/complications* ; Adrenocortical Adenoma/complications* ; Adrenocorticotropic Hormone ; Hydrocortisone ; Retrospective Studies ; Glycated Hemoglobin ; Adrenal Cortex Neoplasms/diagnosis* ; Adenoma/diagnosis* ; Thrombophilia/complications*

Adenoma, Pleomorphic ; complications ; Adult ; Humans ; Male ; Pharyngeal Neoplasms ; complications ; Sleep Apnea, Obstructive ; etiology

Pituitary adenoma with cerebrospinal fluid rhinorrhea is rare clinically. In this paper, through the analysis of a pituitary adenoma patient with initial symptom of cerebrospinal fluid rhinorrhea, we look forward to provide evidence for clinical diagnosis, so that we can avoid misdiagnosis.
Adenoma ; complications ; diagnosis ; Cerebrospinal Fluid Rhinorrhea ; etiology ; Humans ; Pituitary Neoplasms ; complications ; diagnosis

Gastritis cystica profunda is usually characterized by hyperplastic and cystic dilatation of pseudopyloric gland with submucosal invasion. These lesions possess malignant histologic features as metaplastic and even dysplastic alteration can be observed, however they usually exhibit benign behavior. Macroscopically, gastritis cystica profunda may present as a submucosal tumor or as a polyp. In rare case, however, it can be found as a giant mucosal fold. The proposed pathogenesis of lesion relates to ischemia, chronic inflammation, and the presence of foreign body. Herein, we report a case of gastritis cystica profunda associated with high grade tubular adenoma in a patient without antecedent surgery.
Adenoma/*complications/pathology ; English Abstract ; Gastritis/*complications/diagnosis/pathology ; Humans ; Male ; Middle Aged ; Stomach Neoplasms/*complications/pathology

OBJECTIVE: Giant pituitary adenomas are rare. The location of these adenomas are close to vital neural and vascular structures with widespread extensions that makes the radical surgical management difficult. METHODS: From October 1994 to August 1998, we experienced 20 patients with giant pituitary adenomas out of 178 surgically treated pituitary adenoma patients. Giant pituitary adenoma was diagnosed on the basis of the longest diameter of being more than 4cm in MRI scan. We reviewed the clinical presentation, types of tumor, size and degree of suprasellar or parasellar extension, routes of surgical approach, postoperative surgical outcomes and complications. RESULTS: The incidence of giant pituitary adenomas was 11%. The most common chief complaint was visual disturbance(n=16). The non-functioning adenoms(n=16) were the majority and the other 4 patients were functioning adenomas(prolactinoma n=2, acromegaly n=1, cushing's disease n=1). The patients underwent transsphenoidal approach(TSA)(n=15) or transcranial approach(TCA)(n=5). Gross total or subtotal removal were achieved in 60% of TSA group(9 of 15) and 40% of TCA group(2 of 5). Postoperative complications were in 6 patients with TSA; cerebrospinal fluid(CSF) leakages(n=2), postoperative bleeding(n=2), transient diabetes insipidus(DI)(n=2). Visual function was improved in 69%(9 of 13) after TSA and 40% after TCA. Surgical results in the TSA group were better than those in transcranial approach group, and there were fewer and less severe postoperative complications. CONCLUSION: Even in the giant pituitary adenomas, conventional transsphenoidal approach was effective as the initial treatment modality in terms of effective decompression, functional recovery, and low morbidity.
Acromegaly ; Adenoma ; Decompression ; Humans ; Incidence ; Magnetic Resonance Imaging ; Pituitary Neoplasms* ; Postoperative Complications

Endoscopic surgery opened new fields in pituitary tumor surgery, not only by direct endonasal access, but also by affording a panoramic view inside the sphenoidal sinus and the sellar turcica. It provides an extremely sharp image with high resolution. We describe our initial experience in using the endonasal endoscopy for the pituitary tumor surgery. Seven operations were performed by the endonasal endoscopy. The endoclinologic diagnosis were prolactinoma in four cases and GH secreating adenoma in three. Four cases were macroadenoma and three were microadenoma. Among the three patients with GH secreting adenomas, two improved clinically with normal serum GH level, one improved clinically with elevated serum GH levels postoperatively. Of the four patients with prolactinomas, all four improved clinically elevated with serum prolactin levels. Two patients developed postoperative complications; one was transient cerebrospinal fluid(CSF) leakage and the other was transient diabetes insipedus(DI). The use of the endoscope allowed close inspection of sella and parasellar structures as well as differentiation between tumor tissue and normal pituitary gland. Gross total removal was possible with the help of angled view of the telescope even in the cases of moderate supra-and parasellar extensions. Although from short and early experience, endoscopic endonasal approach seems to be a valuable and safe procedure for removing pituitary adenomas. With improved techniques and an accumulation in operative experience, endoscopic pituitary surgery will gain in importance and present new horizons in pituitary surgery.
Adenoma ; Diagnosis ; Endoscopes ; Endoscopy ; Humans ; Pituitary Gland ; Pituitary Neoplasms* ; Postoperative Complications ; Prolactin ; Prolactinoma ; Telescopes