Adrenocortical carcinoma: report of a case]

A 24-year-old man visited our hospital complaining of hypertension and headache. Endocrinological findings revealed no abnormalities except for a slight decrease in serum adrenocorticotropic hormone (ACTH), a slight increase in urine 17-ketosteroid (17-KS), and a marked increase in serum pregnenolone. Computed tomography and magnetic resonance imaging revealed a 3 x 3 cm mass in the right adrenal area and I131-aldosterol scintigraphy demonstrated a high absorption of the isotope in the right adrenal area. Vena cavography suggested a 2 x 2 cm tumor thrombus originating in the right adrenal. Under the diagnosis of the right adrenocortical carcinoma, adrenalectomy and removal of the tumor thrombus were performed. Both serum pregnenolone and urine 17-KS returned to the normal level within a week after the operation and blood pressure was well controlled without any medication 3 months after the operation. Thus, the tumor seemed to be endocrinologically active.     

Adrenocortical carcinoma with Cushing syndrome: report of a case

We report a 45-year-old female with left adrenocortical carcinoma resulting in Cushing syndrome. She visited the 3rd Department of Internal Medicine, Kanazawa University Hospital with complaints of moon face, amenorrhea and hypertension. A diagnosis of left adrenal tumor with Cushing syndrome was made and she was transferred to our clinic. Left thoracoabdominal adrenalectomy was performed. The histologic report was compatible with adrenocortical carcinoma with no invasion into adjunctive tissues. She is now on endocrinologic study and is being administered 1,1-dichloro-2-[o-chlorophenyl]-2[p-chlorophenyl] ethane. There is no evidence of local recurrence or remote metastasis.     

肾上腺皮质癌19例报告

目的探讨肾上腺皮质癌临床特点和治疗方法,提高肾上腺皮质癌的诊治水平。方法回顾性分析经病理确诊的19例肾上腺皮质癌的临床资料。肿瘤直径1～20cm,平均9.3cm,1～5cm4例,5～10cm6例,>10cm9例。Ⅰ期2例,Ⅱ期6例,Ⅲ期5例,Ⅳ期6例。结果手术完整切除13例,姑息性切除4例,仅作活检2例。术后平均生存28个月。其中5例行腹腔镜手术,4例至今生存,1例2年后死于肺转移。结论早期诊断、早期手术是治疗关键,腹腔镜手术也是治疗肾上腺皮质癌有效的方法。     

Spontaneous retroperitoneal hematoma: a case report

The A.A. present a case report of retroperitoneal spontaneous hematoma and put in evidence the difficulties in making an etiopathogenetic diagnosis of spontaneous renal cyst rupture. The patient was a 72 years old man admitted to the hospital in emergency for a painful ipogastric syntomatology and biliary vomit. The ecography showed a distanced gallbladder and the endoscopy evidenced a duodenal stenosis with compression of the gastric posterior wall, so that we were initially directed towards a pancreatic tumor even if the modest increase of the serum bilirubinemy and mostly the fact that direct component was almost normal, gave us strong doubts. The spiral TC gave finally the diagnosis of retroperitoneal hematoma and the presence of a bilateral polycystic kidney with several subcapsular cyst, let us suggest, as well as the anamnestic report of a physical stress, a renal origin of the bleeding. A wild literature review did not evidence other similar cases, but the ecclusion of other possible causes of retroperitoneal hematoma, suggested this conclusion.     

Huge retroperitoneal leiomyosarcoma: a case report

This is a case report of retroperitoneal leiomyosarcoma in a 61-year-old woman. She presented with a chief complaint of back pain. Computed tomography showed a left huge retroperitoneal tumor. The tumor was removed with left nephrectomy and left hemi-colectomy. Histological examination demonstrated leiomyosarcoma 26 x 20 x 16 cm in diameter and, 3.84 kg in weight. She died of local recurrence causing ileus 2 months after the surgery. Fifty-four cases of retroperitoneal leiomyosarcoma including the present case in the Japanese literature are reviewed.     

Solitary retroperitoneal neurofibroma: a case report

A solitary neurofibroma arising in the retroperitoneal space without any other stagma of von Recklinghausen's disease is reported. Confusion with another nerve sheath tumor, a schwannoma is a diagnostic pitfall. Histochemical and immunohistochemical stainings of the tumor are useful for the diagnosis of solitary neurofibroma.     

The retroperitoneal liposarcoma: a case report

A 62-year-old woman was admitted to our hospital because of a mass in the right abdomen. Ultrasonography, aortography and computed tomographic (CT) scanning revealed the right kidney displaced by a huge and avascular mass containing fatty tissue. Also magnetic resonance imaging (MRI) indicated that it was contained of lipomatous tissue and demonstrated the mass occupying the entire right abdominal cavity. The tumor including the right kidney was resected, following diagnosis of the retroperitoneal tumor. The exercised tumor measured 28 X 22 X 18 cm and weighed 2,010g. The histological diagnosis was well-differentiated liposarcoma. She has been healthy for three months following postoperative chemotherapy. Many reports have been made on the ultrasonographic and CT appearance of retroperitoneal liposarcoma, but few have been made on the MRI appearance. According to our case, imaging diagnosis by MRI also seems to be useful in making a histological diagnosis of liposarcoma.     

The retroperitoneal rhabdomyosarcoma: a case report

A case of rhabdomyosarcoma in the retroperitoneal space is reported. The patient, a 71-year-old man, visited us with a complaint of left flank pain. The tumor measuring 13 x 10 x 7 cm and weighing 700 g, was removed operatively. The patient had no evidence of recurrence in 12 months following surgery.     

Extrarenal retroperitoneal epithelioid angiomyolipoma: a case report

We present a very rare case of retroperitoneal extrarenal epithelioid angio-myolipoma (AML). A 64-year-old man without tuberous sclerosis was admitted to our hospital for further examination of an abdominal mass lesion. Imaging analyses revealed a heterodensity and heterointensity retroperitoneal mass covering the left renal surface by ultrasonography, computed tomography and magnetic resonance imaging. Surgical exploration was done, and the tumor was resected with the left kidney radically. Histopathologically high cellular atypia was remarkable, and diagnosis was extrarenal epithelioid AML because of consistent immunostaining positive for HMB-45.     

Giant retroperitoneal liposarcoma: report of a case

Liposarcoma is a rare and primary malignancy developed from mesenchymal tissue. We report the case of a 32-year-old woman who had a complete exeresis of a 15 cm retroperitoneal myxoid liposarcoma. Three months later, a 9 cm local recurrence was excised and radiotherapy was performed. In 2000, a local recurrence and an intestinal localisation of the liposarcoma were observed. The retroperitoneal tumor could not be removed and she had an intestinal resection followed by chemotherapy. With the literature data, we review the pathological, therapeutic and prognostic aspects of this tumor.     

Spondyloarthropathy and retroperitoneal fibrosis: a case report

Retroperitoneal fibrosis is an uncommon inflammatory condition in which the retroperitoneal tissue is transformed into a tight sheet of fibrous tissue. It can occur in association with various diseases, including rheumatic conditions. We report a new case in a 66-year-old man with spondyloarthropathy. Nine similar cases have been reported. Axial manifestations predominated, and half the patients carried the HLA-B27 antigen. The relation between retroperitoneal fibrosis and spondyloarthropathy remains controversial.     

腹膜后巨大囊性淋巴管瘤1例

病例:女,28岁,因左侧腰背部酸痛3月余入院。病程中无放射痛,无发热、乏力、纳差等。体检无血压升高、无贫血、黄疸,腹平软,未及明显肿块,无压痛,无肾区叩击痛;各项实验室指标包括血常规、肝肾功能、血糖、肿瘤标志物均正     

Adrenocortical oncocytoma: a case report and review of literature

Oncocytic tumors of the adrenal gland are uncommon. Most of these oncocytomas are benign and nonfunctioning. We report the case of functioning adrenocortical located in the right adrenal gland in a 6-year-old girl who presented with pseudoprecocious puberty and elevation of the estradiol level. She had an adrenalectomy. The tumor was small and composed predominantly of oncocytes. No criteria of malignancy were found. A discussion of this case and a review of the literature on this entity are presented.     

Adrenocortical carcinoma versus renal cell carcinoma with vena caval thrombus: A case report and review

Intravascular tumor thrombus may develop in certain malignancies, including renal cell carcinoma and adrenocortical carcinoma. Renal cell carcinoma is far more common than adrenocortical carcinoma, but it can be difficult to differentiate them. In fact, they have different clinical and radiological features, as well as prognosis. Surgical planning and clinical management between them are different. We report a patient with inferior vena cava thrombus originating from adrenocortical carcinoma mimicking renal cell carcinoma clinically. Case reports and articles about adrenocortical carcinoma are reviewed.     

Systemic lupus erythematosus presenting as a brainstem infarction and hemorrhage during treating retroperitoneal abscess: a case report

We report a case of a brainstem infarction and hemorrhage seen in a 21-year-old female with systemic lupus erythematosus (SLE) during treating retroperitoneal abscess. SLE has been treated with prednisolone and mizoribine for 4 years. The patient with right back and lower abdominal pain visited our hospital. Computed tomography (CT) revealed retroperitoneal abscess over surrounding right kidney, horizontal part of duodenum and in front of psoas muscle. Drainage was done with indwelled right single J catheter and penrose drain. Retroperitoneal abscess was much smaller, but, post drainage day 17, high fever, unconsciousness, down-blood pressure and down-beat nystagmus appeared suddenly. Brain CT scan revealed a brainstem wide infarction and hemorrhage spot. Pulse therapy with steroid was done, however unfortunately the patient was dead after 6 days.     

Idiopathic retroperitoneal fibrosis diagnosed by CT-guided needle biopsy: a case report

A 72-year-old man was admitted to another hospital because of general fatigue and dyspnea secondary to renal insufficiency. Abdominal computed tomography (CT) and magnetic resonance imaging showed left atrophic kidney, right hydronephrosis, and an intra-pelvic mass of soft-tissue density located anterior to the sacrum, involving the right ureter at the level between the 5th lumber vertebra and the sacrum. He was referred to our hospital after percutaneous nephrostomy was constructed into right kidney. CT-guided needle biopsy revealed the idiopathic retroperitoneal fibrosis, leading us to give him steroid therapy. Three weeks later, radiographic findings showed a remarkable reduction of the mass and the improvement of the right ureteral stricture.     

Retroperitoneal paraganglioma incidentally detected by health examination: a case report

We report a case of non-functioning retroperitoneal paraganglioma detected incidentally by health examination in a 60-year-old female without any clinical manifestation. She was admitted to our hospital for the purpose of evaluation of a renal mass detected by ultrasound sonography. Computed tomography, magnetic resonance imaging and angiography revealed the heterogeneously-enhanced 10 x 10 cm mass in the left retroperitoneal space without any distant metastasis. It was suspected to be a renal cell carcinoma. All laboratory data, including those from endocrinological examinations, were within normal ranges. Radical nephrectomy was performed to resect en bloc the mass and the left kidney. The pathological and immunohistochemical examinations of the mass which was completely separated from the kidney and the adrenal gland, showed characteristic features of paraganglioma with vascular and capsular invasion, with a final clinical diagnosis of the pathologically-malignant non-functioning paraganglioma occurring between the left kidney and the adrenal gland.     

A case report: renal arteriovenous malformation associated with horseshoe kidney detected by hemorrhage due to injury

A case report of a patient with renal arteriovenous malformation associated with horseshoe kidney detected by hemorrhage due to injury. A 71-year-old man was injured in a traffic accident and conveyed to our hospital. The computed tomographic scan showed renal injury of the horseshoe kidney with retroperitonial hemorrhage. We treated him conservatively, but he complained of abdominal fullness and went into hemorrhagic shock. So, we performed arterial angiography. It showed a right renal arteriovenous malformation from which leakage of contrast medium was detected. Hemostasis was possible by embolization of the abnormal artery. He has not had any recurrence of renal arteriovenous malformation. To our knowledge, this case is the third report of renal arteriovenous malformation associated with horseshoe kidney in Japan.