1.Retroperitoneal Tumors Mimicking Adrenal Tumor.
Dong Ju KIM ; Lee Chan JANG ; Jae Woon CHOI ; Jin Woo PARK
Korean Journal of Endocrine Surgery 2012;12(1):31-33
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
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Carcinoma, Renal Cell
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Diagnosis
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Diagnosis, Differential
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Teratoma
3.A Case of Primary Adrenal Gland Lymphoma.
Jae Hee YOON ; Young Yiul LEE ; Chan Gum PARK ; Byung Hee KOE ; In Soon KIM
The Korean Journal of Internal Medicine 2003;18(2):122-124
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
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Human
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Lymphoma, Large-Cell/*diagnosis/therapy
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Male
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Middle Aged
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Treatment Outcome
4.Adrenocorticotropic hormone-producing pheochromocytoma: a case report and review of the literature.
Xun-gang LI ; Dong-xu ZHANG ; Xiang LI ; Xin-gang CUI ; Dan-feng XU ; Yao LI ; Yi GAO ; Lei YIN ; Ji-zhong REN
Chinese Medical Journal 2012;125(6):1193-1196
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
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Adrenal Gland Neoplasms
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diagnosis
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secretion
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therapy
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Adrenocorticotropic Hormone
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secretion
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Female
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Humans
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Pheochromocytoma
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diagnosis
;
secretion
;
therapy
6.Adrenal paragonimiasis simulating adrenal tumor: a case report.
Seong Tae HAHN ; Seog Hee PARK ; Choon Yul KIM ; Kyung Sub SHINN
Journal of Korean Medical Science 1996;11(3):275-277
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
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Adrenal Gland Neoplasms/*diagnosis
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Aged
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Case Report
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Human
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Male
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Paragonimiasis/*diagnosis/radiography/ultrasonography
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Support, Non-U.S. Gov't
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Tomography, X-Ray Computed
7.A Case of a Composite Adrenal Medullary Tumor of Pheochromocytoma and Ganglioneuroma Masquerading as Acute Pancreatitis.
Eun Kyoung CHOI ; Wan Ho KIM ; Keun Yong PARK
The Korean Journal of Internal Medicine 2006;21(2):141-145
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
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Pancreatitis/*etiology
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Neoplasms, Multiple Primary/*diagnosis
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Middle Aged
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Male
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Humans
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Ganglioneuroma/*diagnosis
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*Adrenal Medulla
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Adrenal Gland Neoplasms/*diagnosis
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Acute Disease
8.Usefulness of F-18 FDG PET/CT in Adrenal Incidentaloma: Differential Diagnosis of Adrenal Metastasis in Oncologic Patients.
Hong Je LEE ; Bong Il SONG ; Sung Min KANG ; Shin Young JEONG ; Ji Hyoung SEO ; Sang Woo LEE ; Jeongsoo YOO ; Byeong Cheol AHN ; Jaetae LEE
Nuclear Medicine and Molecular Imaging 2009;43(5):421-428
PURPOSE: We have evaluated characteristics of adrenal masses incidentally observed in nonenhanced F-18 FDG PET/CT of the oncologic patients and the diagnostic ability of F-18 FDG PET/CT to differentiate malignant from benign adrenal masses. MATERIALS AND METHODS: Between Mar 2005 and Aug 2008, 75 oncologic patients (46 men, 29 women; mean age, 60.8+/-10.2 years; range, 35-87 years) with 89 adrenal masses incidentally found in PET/CT were enrolled in this study. For quantitative analysis, size (cm), Hounsfield unit (HU), maximum standardized uptake value (SUVmax), SUVratio of all 89 adrenal masses were measured. SUVmax of the adrenal mass divided by SUVliver, which is SUVmax of the segment 8, was defined as SUVratio. The final diagnosis of adrenal masses was based on pathologic confirmation, radiologic evaluation (HU<0 : benign), and clinical decision. RESULTS: Size, HU, SUVmax, and SUVratio were all significantly different between benign and malignant adrenal masses.(P < 0.05) And, SUVratio was the most accurate parameter. A cut-off value of 1.0 for SUVratio provided 90.9% sensitivity and 75.6% specificity. In small adrenal masses (1.5 cm or less), only SUVratio had statistically significant difference between benign and malignant adrenal masses. Similarly a cut-off value of 1.0 for SUVratio provided 80.0% sensitivity and 86.4% specificity. CONCLUSION: F-18 FDG PET/CT can offer more accurate information with quantitative analysis in differentiating malignant from benign adrenal masses incidentally observed in oncologic patients, compared to nonenhanced CT.
Adrenal Gland Neoplasms
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Diagnosis, Differential
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Humans
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Male
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Neoplasm Metastasis
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Sensitivity and Specificity
9.Comparison of Laparoscopic and Conventional Open Resection of Pheochromocytoma.
Jung Mook KANG ; Jae Young CHOI ; Kil Yeon LEE ; Sang Mok LEE ; Ho Chul PARK ; Sung Wha HONG ; Soo Myung OH ; Choong YOON ; Suck Hwan KOH
Journal of the Korean Surgical Society 2006;70(4):312-316
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
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Adrenalectomy
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Antihypertensive Agents
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Diagnosis
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Diet
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Hemodynamics
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Length of Stay
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Pathology
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Pheochromocytoma*
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Retrospective Studies
10.CT Differentiation of Adrenal Pheochromocytoma from Primary Carcinoma and Metastasis.
Jong Kyu KIM ; Jae Young BYUN ; Jung Whee LEE ; Ki Jun KIM ; Kang Hoon LEE ; So Lyoung JUNG ; Sung Eun RHA ; Ho Jong CHUN ; Hye Seong PARK ; Jae Mun LEE ; Kyung Sub SHINN
Journal of the Korean Radiological Society 1996;35(3):385-389
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
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Diagnosis
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Female
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Humans
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Male
;
Neoplasm Metastasis*
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Pheochromocytoma*
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Retrospective Studies