Periadrenal retroperitoneal tumors are frequently misdiagnosed as adrenal tumors because of its rarity and anatomical vicinity. Thus, there are only very few cases reported and little information available in the literature. Preoperative diagnoses of theses tumors are challenging. The definitive diagnosis is based on postoperative pathological findings. We report two cases of periadrenal retroperitoneal tumors that mimicked adrenal neoplasms. Final diagnoses were mature cystic teratoma and papillary renal carcinoma, respectively. Although periadrenal retroperitoneal tumors are rare, it should be considered in the differential diagnosis of adrenal incidentalomas.
Adrenal Gland Neoplasms ; Carcinoma, Renal Cell ; Diagnosis ; Diagnosis, Differential ; Teratoma

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

Primary adrenal lymphoma is extremely rare. We describe a case of non-Hodgkin's lymphoma of diffuse large B-cell type with right adrenal involvement. The patient received chemotherapy and external irradiation and achieved complete remission of the disease. We describe the case of primary adrenal lymphoma with a review of the literature on this unusual neoplasm. Primary adrenal lymphoma should be included in the differential diagnosis of adrenal mass.
Adrenal Gland Neoplasms/*diagnosis/therapy ; Human ; Lymphoma, Large-Cell/*diagnosis/therapy ; Male ; Middle Aged ; Treatment Outcome

Ectopic Cushing’s syndrome caused by pheochromocytoma is rare. We reported a 15-year-old female patient who was admitted to hospital with typical Cushing’s syndrome. She had not started menstruation. Her plasma adrenocorticotropic hormone (ACTH) and 24-hour urinary free cortisol levels were extremely high. Gonadal and progestational hormone levels were also abnormal. Abdominal computed tomography scans and enhanced scans revealed multiple irregular tumors in the right adrenal. Pelvic echogram showed an infantile uterus, while the ovaries were at an immature stage of development. Retroperitoneal laparoscopic right adrenalectomy was performed without intraoperative complications. Histology and immunohistochemistry of the tumor were consistent with pheochromocytoma. Retroperitoneal laparoscopic adrenalectomy is a safe procedure with satisfactory outcomes and allows for rapid recovery.
Adolescent ; Adrenal Gland Neoplasms ; diagnosis ; secretion ; therapy ; Adrenocorticotropic Hormone ; secretion ; Female ; Humans ; Pheochromocytoma ; diagnosis ; secretion ; therapy

Adenomatoid Tumor ; diagnosis ; Adrenal Gland Neoplasms ; diagnosis ; Adult ; Humans ; Male ; Tomography Scanners, X-Ray Computed

We describe a case of adrenal paragonimiasis with its computed tomographic and ultrasonographic findings. Computed tomogram showed a well enhancing oval mass at right adrenal gland and ultrasonogram showed a dumbbell-shaped hyperechoic mass saddling on the top of the right kidney. Surgical specimen was multicystic mass filled with creamy material.
Adrenal Gland Diseases/*diagnosis ; Adrenal Gland Neoplasms/*diagnosis ; Aged ; Case Report ; Human ; Male ; Paragonimiasis/*diagnosis/radiography/ultrasonography ; Support, Non-U.S. Gov't ; Tomography, X-Ray Computed

Composite adrenal medullary tumors, composed of both pheochromocytoma and ganglioneuroma, are extremely rare, as are pheochromocytomas masquerading as acute relapsing pancreatitis. We recently experienced a case of a 48-year-old male with both these phenomena. The patient complained of an acute onset of intense abdominal discomfort. At the same time, pancreatic enzymes were increased in concentration. An abdominal computed tomographic scan revealed an enlarged pancreas and a 3-cm left adrenal incidentaloma. Biochemical and 131I-MIBG scintigraphic findings were compatible with a pheochromocytoma. Yet, he had no clinical manifestations suggesting pheochromocytoma. An adrenalectomy was performed and a composite adrenal medullary tumor of pheochromocytoma and ganglioneuroma was confirmed during a pathologic examination. This case illustrates two points: 1) acute abdominal intense discomfort and hyperamylasemia may be unusual presentations of pheochromocytomas; and 2) the possibility of the pheochromocytoma, albeit rare, should be considered when a relapsing pancreatitis of uncertain etiology develops.
Pheochromocytoma/*diagnosis ; Pancreatitis/*etiology ; Neoplasms, Multiple Primary/*diagnosis ; Middle Aged ; Male ; Humans ; Ganglioneuroma/*diagnosis ; *Adrenal Medulla ; Adrenal Gland Neoplasms/*diagnosis ; Acute Disease

PURPOSE: To evaluate the efficacy of CT imaging in differentiating pheochromocytoma from primary adrenalcarcinoma and metastasis. MATERIALS AND METHODS: The authors retrospectively reviewed CT imagings of 24 patients(9 males, 15 females, mean age 49) with 27 surgically or clinically proven adrenal neoplasms larger than 3cm indiameter. These neoplasms included pheochromocytomas(n=11), adrenal carcinomas(n=6), and adrenal metastases(n=10,bilateral : 3). Two radiologists visually inspected CT features with respect to tumor size, shape, intratumoral hypodensity, and calcification, and agreed upon their evalvation. These results were compared with the final histopathologic and clinical diagnosis. RESULTS: Ten of eleven pheochromocytomas(91%) were observed to be round or ovoid; this shape was rarely seen in primary carcinomas(0/6) or metastases(2/10). in contrast, mostcarcinomas(6/6, 100%) were lobulated or irregular in shape, as were most metastases(8/10, 80%). smooth, round orovoid intratumoral hypodensity was noted in all pheochromocytomas. Stellate or linear, irregular intratumoral hypodensity was present in all carcinomas and metastases. However, there were no significant differences in CTdensity of calcification. CONCLUSION: Tumor shape and intratumoral hypodensity are very useful CT findings for differentiating adrenal pheochromocytomas from primary carcinomas and metastases.
Adrenal Gland Neoplasms ; Diagnosis ; Female ; Humans ; Male ; Neoplasm Metastasis* ; Pheochromocytoma* ; Retrospective Studies

OBJECTIVETo study and summarize the diagnosis and treatment for the corticomedullary mixed tumor of adrenal gland.

METHODSThe clinical data of 25 cases of adrenal corticomedullary mixed tumor from January 2000 to April 2008 were analyzed retrospectively, which including 9 males and 16 females. The ages were from 25 to 60 years old, and the average age was 39 years old. Thirteen cases had paroxysmal hypertension and 11 cases had central obesity, as well as 8 cases with hypokalemia. There were different degree abnormalities in plasma endocrine hormones in laboratory examination. Every case underwent b-ultrasound and CT normal plus extensive scan to make the diagnosis.

RESULTSAdrenalectomy was performed in the 25 cases, which contain 9 cases of open operations and 16 cases of endoscopic adrenalectomies. All of the cases had blood pressure fluctuation during dissection of the adrenal tumors, with the highest blood pressure reached to 230/140 mm Hg (1 mm Hg = 0.133 kPa). Postoperative histopathological study revealed that the pathological changes was corticomedullary mixed tumor of adrenal gland, which was supported by immunohistochemical study.

CONCLUSIONSIn cases with complex phenomenon that can't explain with single cortical or medullary changes, it must beware of the mixed pathological changes in adrenal gland.

Adrenal Gland Neoplasms ; diagnosis ; surgery ; Adrenalectomy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies

PURPOSE: Laparoscopic adrenalectomy (LA) has become the standard treatment for benign adrenal neoplasm because of the procedure's minimal invasiveness and the patients' earlier recovery. The aim of this study was to evaluate the safety and effectiveness of laparoscopic adrenalectomy for treating pheochromocytoma. METHODS: 19 Operations were performed between March 1993 and July 2004 at Kyung-Hee medical center for treating pheochromocytoma, and the diagnosis was confirmed by the postoperative pathology. There were 5 cases treated with LA and 14 cases treated with open adrenalectomy (OA). The various clinical parameters (tumor location, tumor size, first oral feeding, hospital stay, hemodynamic change and operation time) were compared between the LA and OA procedures, retrospectively. RESULTS: The location of the tumor was 2 : 2 : 1 (left : right : extra-adrenal) in the LA group and 9 : 3 : 2 (left : right : both) in the OA group. The mean tumor size (cm) was 5.4 in the LA group and 6.3 in the OA group. The mean operation time (minutes) was 219 in the LA group and 202 in the OA group. The resumption of liquid diet (days) was 2.2 in the LA group and 3.0 in the OA group (P=0.037). The postoperative hospital stay (days) was 6.3 in the LA group and 8.5 in the OA group. The mean number of intraoperative hypertensive crisis was 1.42 in the LA group and 1.40 in the OA group. The number of cases requiring intraoperative transfusion was 2 of 5 in the LA group and 2 of 15 in the OA group. The use of antihypertensives (number of times) was 1.42 in the LA group and 1.40 in the OA group. The mean highest BP (mmHg) was 162 in the LA group and 165 in the OA group. CONCLUSION: Laparoscopic adrenalectomy for treating pheochromocytoma is a safe and effective procedure that provides the benefits of a minimally invasive approach.
Adrenal Gland Neoplasms ; Adrenalectomy ; Antihypertensive Agents ; Diagnosis ; Diet ; Hemodynamics ; Length of Stay ; Pathology ; Pheochromocytoma* ; Retrospective Studies