BACKGROUNDAlveolar echinococcosis located in the adrenal gland can be considered a rare and aggressive infestation that radiologically and macroscopically mimics a malignant neoplasm. Its pathogenesis is poorly understood. This paper describes its clinical and radiological aspects and discusses its proper management.

METHODSThe records of two patients with adrenal gland alveolar echinococcosis who were diagnosed and treated in our center in 2009 were evaluated.

RESULTSNeither patient showed any signs of recurrence following radical surgical treatment and postoperative oral anthelmintic therapy.

CONCLUSIONRadical surgery can be a feasible, effective management option that results in a good prospective outcome.

Adrenal Glands ; pathology ; surgery ; Echinococcosis, Hepatic ; diagnosis ; surgery ; Female ; Humans ; Male ; Middle Aged

Adrenal Gland Neoplasms ; pathology ; surgery ; Adrenal Glands ; pathology ; surgery ; Child, Preschool ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Granuloma, Plasma Cell ; pathology ; surgery ; Histiocytoma, Malignant Fibrous ; pathology ; Humans ; Neoplasms, Muscle Tissue ; pathology ; surgery

Adrenal Glands ; metabolism ; Androgens ; metabolism ; Gene Amplification ; Humans ; Male ; Orchiectomy ; Prostatic Neoplasms ; metabolism ; pathology ; surgery ; Receptors, Androgen ; metabolism

OBJECTIVETo investigate the factors regarding the recovery of postoperative blood pressure of aldosterone producing adenoma (APA) patients.

METHODSSixty-eight patients with APA were recruited and their data including retinal blood vessel by Doppler sonography, urinary trace albumin, pathological changes of renal biopsy and the adrenal tissues around the adenoma were analyzed in order to determine the correlation between these data and postoperative durative hypertension.

RESULTSPostoperative durative hypertension occurred in 14 cases (41.2%) with increased resistance of unilateral or bilateral central artery of retina, in 16 cases (66.7%) with increased level of urinary trace albumin. Fifteen cases underwent renal biopsy and all of them showed different pathological alterations, 11 cases (73.3%) of which presented with postoperative durative hypertension. The pathological changes of the adrenal tissues around the adenoma is either atrophy or non-atrophy (normal or hyperplasia), 8 cases (40%) and 10 cases (22.2%) of which showed postoperative durative hypertension, respectively.

CONCLUSIONThe renal pathological changes and increased resistance of retinal blood vessel are the main reasons leading to postoperative hypertension in patients with APA.

Adolescent ; Adrenal Cortex Neoplasms ; physiopathology ; surgery ; Adrenal Glands ; pathology ; Adrenocortical Adenoma ; physiopathology ; surgery ; Adult ; Blood Pressure ; physiology ; Female ; Humans ; Hyperaldosteronism ; etiology ; physiopathology ; surgery ; Hypertension ; etiology ; Kidney ; pathology ; Male ; Middle Aged ; Postoperative Period ; Retinal Artery ; physiopathology ; Retrospective Studies ; Vascular Resistance ; physiology

Pheochromocytoma is one of the potentially fatal causes of childhood hypertension. The study aims to analyze the results of our experiences in pheochromocytomas and the long-term results of its surgical treatment in children. The records of 15 children (11 boys, 4 girls) treated for pheochromocytoma in our unit during the period of 1984 and 2002 were reviewed retrospectively. The average age at surgery was 11.7 yr (range 6 yr 9 months-15 yr 7 months). Localized disease is defined as the cases without the invasion of surrounding tissue, regional disease as the invasion of surrounding tissue and metastatic disease as distant metastases. The mean follow-up after pheochromocytoma excision was 95 months (range 5 to 221 months). Tumors were located in the adrenal gland in 11 (bilaterally in 4) and extra-adrenally in 4. Localized disease occurred in 14 patients and regional disease in one. Only one patient was associated with von Hippel Lindau syndrome. Adrenalectomy or total excision of extra adrenal tumor was performed. Four patients (26.7%) recurred after the first operation (at 2 yr 9 months to 14 yr) and regional disease recurred in one patient three times. Early diagnosis, surgical excision, and long-term follow up are most important for the appropriate treatment of childhood pheochromocytoma.
Adolescent ; Adrenal Gland Neoplasms/surgery ; Adrenal Glands/pathology ; Adrenalectomy ; Child ; Chromaffin Cells/pathology ; Female ; Follow-Up Studies ; Hippel-Lindau Disease/pathology ; Human ; Hypertension/etiology ; Male ; Neoplasm Metastasis ; Pheochromocytoma/*surgery ; Recurrence ; Retrospective Studies ; Time Factors ; Treatment Outcome

In patients with primary aldosteronism who have bilateral adrenal incidentalomas, it is important to identify which adrenal gland is secreting excess aldosterone. Traditionally, adrenal vein sampling (AVS) has been performed for lateralization despite its invasiveness. Here we report a case of bilateral adrenal incidentaloma in which 18-Fluorodeoxyglucose (FDG)-positron emission tomography (PET) was used to identify the functional adrenal mass. A 53-yr-old man was referred to our clinic due to bilateral adrenal incidentalomas (right: 1 cm, left: 2.5 cm) on computed tomography (CT). Given his history of colon cancer, FDG-PET/CT scanning was used to rule out metastasis. Although there was focal hot uptake lesion in the right adrenal gland, the patient was suspected primary aldosteronism clinically more than metastasis because of the patient's underlying hypertension with hypokalemia. It was consistent with the results of AVS. Based on these findings, we propose that FDG-PET/CT can be used instead of AVS to identify the source of primary aldosteronism between two bilateral adrenal incidentalomas.
Adrenal Gland Neoplasms/*diagnosis/pathology/radionuclide imaging ; Adrenal Glands/pathology/surgery ; Fluorodeoxyglucose F18/diagnostic use ; Humans ; Hyperaldosteronism/*diagnosis/pathology ; Hypertension/diagnosis ; Hypokalemia/diagnosis ; Male ; Middle Aged ; Positron-Emission Tomography and Computed Tomography

PURPOSE: A laparoscopic procedure is considered the treatment of choice for an adrenalectomy. We report our experience of a laparoscopic transperitoneal adrenalectomy in a series of 41 patients. MATERIALS AND METHODS: Between February 1999 and September 2004, 41 consecutive patients underwent a laparoscopic transperitoneal adrenalectomy. The indications for a adrenalectomy were primary aldosteronism in 16 patients, Cushing's syndrome in 7, pheochromocytoma in 6, nonfunctional adenoma in 5, adrenal cyst in 3, benign cystic teratoma in 2, myelolipoma in 1 and metastatic renal cell carcinoma in 1. The author analyzed the results of each operation. RESULTS: The affected adrenal gland was successfully removed, with the exception of 3 cases. Conversion to open surgery was necessary in 3 of the pheochromocytoma patients due to massive intraoperative bleeding and severe adhesion to retroperitoneal fat. The mean operative time was 245.3 minutes (125-420). The mean intraoperative blood loss and adrenal mass size were 189.6ml (20-2100) and 3.6cm (1.0-10.4), respectively. The mean post-operative hospital stay was 10.4 days (5-29). The mean times to oral intake and ambulation were 1.4 (1-3) and 1.0 days (1-2) after the operation, respectively. The mean number of days of analgesic administration was 2.1 (0-6). The conversion and major complication rates were 7.3 and 10.5%, respectively. CONCLUSIONS: A laparoscopic adrenalectomy is safe and effective in nearly all adrenal pathologies, with early oral intake, ambulation and a low number of days of pain control.
Adenoma ; Adrenal Glands ; Adrenalectomy* ; Carcinoma, Renal Cell ; Conversion to Open Surgery ; Cushing Syndrome ; Hemorrhage ; Humans ; Hyperaldosteronism ; Intra-Abdominal Fat ; Laparoscopy ; Length of Stay ; Myelolipoma ; Operative Time ; Pathology ; Pheochromocytoma ; Teratoma ; Walking