1/8. Adrenal tumor with caval extension--case report and review of the literature.Extension of adrenal cortical carcinomas into the IVC is rare. We describe one such tumor that extended to the level of the right atrium. In an effort to aid recognition and guide work-up of an upper pole lesion, we review the literature comprised of 77 similar cases and analyze the data in terms of patient demographics, anatomic distribution, clinical and laboratory evidence of endocrine function. Our review suggests that over half of all adrenal lesions with IVC extension will be clinically nonfunctional, including up to 17% of pheochromocytomas.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
2/8. Virilising adrenocortical carcinoma.A 16-year-old, Hindu, female presented with rapidly growing abdominal lump for 6 months, primary amenorrhoea and non-development of secondary sex characters. Her BP was 180/120 mmHg. There was an excessive hirsutism involving face, neck, shoulders, abdomen and thighs. A lump was felt at left lumbar region extending on to left hypochondrium and part of umbilical region. Her serum testosterone level was 224 ng/dl and cortisol level was 15 microg/dl. ultrasonography revealed a solid mass arising from the upper pole of left kidney. Exploratory laparotomy revealed a huge left adrenal tumour which was removed completely. Histopathology of the resected mass showed sheets of large round to polyhedral cells with hyperchromatic nuclei and eosinophilic granular cytoplasm with numerous giant cells. The case was diagnosed as virilising adrenocortical carcinoma.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
3/8. Nonfunctioning adrenocortical carcinoma in a child.Pediatric nonfunctioning adrenocortical carcinoma is a very rare tumor. A 4-year-old girl was admitted complaining of abdominal pain. physical examination revealed an abdominal mass. There were no clinical or laboratory signs of hormonal abnormality. Abdominal ultrasonography revealed a polylobular mass. Intravenous pyelography showed marked compression of the kidney by a tumor. The tumor was excised together with the right kidney. The histopathological diagnosis was adrenocortical carcinoma. Although there is a greater incidence of germ line p53 mutations with adrenocortical carcinoma, the tumor suppressor gene p53 was not mutated in our case. The girl died 2 months after surgery from complications of chemotherapy.- - - - - - - - - - ranking = 31.647166035695keywords = abdominal pain (Clic here for more details about this article) |
4/8. Haemorrhagic shock from the spontaneous rupture of an adrenal cortical carcinoma. A case report.Adrenal cortical carcinoma is a rare endocrine neoplasm which can be either functioning or non-functioning. Usually, patients refer to the doctor because of abdominal pain or symptoms associated with the mass effect. We present an unusual case of a patient with adrenal cortical carcinoma who was immediately operated due to massive retroperitoneal haemorrhage following the spontaneous rupture of the tumour. Adrenal cortical carcinoma should enter in differential diagnosis of retroperitoneal haemorrhage. Surgeons should be familiar with this clinical entity and attempt complete resection if possible.- - - - - - - - - - ranking = 31.647166035695keywords = abdominal pain (Clic here for more details about this article) |
5/8. Functioning adrenocortical carcinoma with superior vena cava and upper airway obstructions.BACKGROUND: adrenocortical carcinoma (ACC) is one of the most aggressive endocrine malignancies with a dismal prognosis. Typically, the tumor is large and has regional invasion or distant metastasis at initial presentation. OBJECTIVE: To describe an unusual case of functioning ACC presenting with superior vena cava (SVC) and upper airway obstruction. MATERIAL AND METHOD: A 23-year-old man with cushingoid appearance was evaluated for a neck mass and SVC syndrome. Hormonal assessment and neck mass biopsy including immunohistochemistry study were performed RESULTS: Cushing's syndrome was confirmed by elevated 24-hr urinary free cortisol and no suppressible cortisol level after standard low dose (2 mg/day) of dexamethasone suppression test. Computerized tomography (CT) study revealed a huge left suprarenal mass and multiple mediastinal lymph nodes compressing SVC and trachea. Histopathological findings of the neck mass were compatible with metastatic ACC. CONCLUSION: The present report describes a functioning ACC patient with an unusual metastatic site causing SVC and upper airway obstruction. His hospital course was progressively worsened due to peptic perforation and decompensated respiratory failure, which led him to expire.- - - - - - - - - - ranking = 6keywords = upper (Clic here for more details about this article) |
6/8. Surgical complications after resection of adrenal carcinoma.A 76-year-old woman with a history of dyspnoea, weight loss and abdominal pain, was admitted to our Hospital. Sonographic and tomographic examinations showed the presence of a large adrenal gland tumor and the promptly performed adrenalectomy and splenectomy proved that the lesion was an adrenal gland carcinoma infiltrating the spleen. One month after surgical treatment, the patient's general condition dramatically worsened due to development of perirenal abscess and renal infarction; finally, the patient died. In accordance with literature, we decided to only perform adrenalectomy and splenectomy that are the treatment of choice in these cases. In fact, complications are unforeseeable and avoiding the resection of the kidney surely offered the patient a better life quality.- - - - - - - - - - ranking = 31.647166035695keywords = abdominal pain (Clic here for more details about this article) |
7/8. Adrenal cortical carcinoma with tumor thrombus invasion of inferior vena cava.A case of adrenal cortical carcinoma with inferior vena cava (IVC) involvement is presented. ultrasonography, computed tomography, and venacavography all presumptively showed a large mass over the upper pole of the left kidney with tumor thrombus in the IVC. However, aortography demonstrated that this mass was receiving its blood supply from the left inferior phrenic artery, aorta, and left renal artery. Radical surgery, including resection of the tumor and its adjacent organs (kidney, distal pancreas, spleen) and the tumor thrombus in the IVC, with the aid of cardiopulmonary bypass, was performed. We emphasize that adrenal cortical carcinoma can have tumor thrombi invading the IVC, and in such cases we suggest radical surgical removal of the tumor and the thrombus.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
8/8. Rapid extension of left adrenocortical carcinoma into the right atrium.adrenocortical carcinoma is a rare tumor which can extend into the right heart via the inferior vena cava. We describe a case of a 26-year-old woman who had progressive shortness of breath, intermittent chest pain, and peripheral edema. A two-dimensional echocardiogram on hospital admission showed a large multinodular mass in the right atrium which extended into the inferior vena cava. Further studies showed that this mass was adrenocortical carcinoma. An echocardiogram performed 3 weeks before admission was completely normal. It appears that an adrenocortical carcinoma is capable of rapid growth up the inferior vena cava and into the right atrium.- - - - - - - - - - ranking = 1.1896214169822keywords = chest (Clic here for more details about this article) |