Aldosterone-producing gigantic adrenocortical adenoma with calcifications and cysts

We report on an aldosterone-producing gigantic adrenocortical adenoma with calcifications and cysts, which we believe is rare.     

A case of adrenal pheochromocytoma with contralateral adrenocortical adenoma

A case of a pheochromocytoma in the right adrenal gland and adrenocortical adenoma in the left adrenal gland of a 58-year-old male is reported. The patient was incidentally found to have a right adrenal tumor by ultrasonographic study. A computerized tomographic (CT) study and magnetic resonance image (MRI) study revealed bilateral adrenal tumors. The sizes of the right tumor and left tumor were 2.5 x 3.5 cm and 1.2 x 1.0 cm, respectively. The intensity of each tumor was different on T2-weighted MRI. 131I-MIBG scintigram showed the uptake of right adrenal gland. The existence of pheochromocytoma was confirmed by the elevated levels of catecholamines. We performed venous sampling to be certain whether the patient had unilateral or bilateral pheochromocytoma. As a result, bilateral adrenal pheochromocytoma was diagnosed. Therefore, we performed bilateral adrenalectomy. However, histopathological examination revealed right pheochromocytoma and left non-functioning adrenocortical adenoma.     

Hemorrhagic adrenocortical adenoma with myelolipoma: a case report

We present a case of hemorrhagic adrenocortical adenoma with myelolipoma. A 66-year-old woman was admitted to our hospital for left retroperitoneal mass. Based on abdominal computed tomography, magnetic resonance imaging and blood tests, preoperative diagnosis was a sarcoma of renal capsule origin. En bloc resection of adrenal gland, tumor, and the kidney with lymph node dissection was performed. Histologically, the mass was diagnosed as hemorrhagic adrenocortical adenoma with myelolipomatous foci.     

Two cases of nonfunctioning adrenocortical adenoma

Two cases of benign nonfunctioning adrenocortical adenoma found incidentally by computerized tomography (CT)scan are presented. One patient had some abnormal values in subsequent endocrine studies, but did not have any recognizable clinical syndromes. The adenomas were removed surgically.     

A case of adrenocortical adenoma coexisting with gastrointestinal stromal tumor

A 48-year-old man was referred to our institute for the evaluation of a concomitant gastric submucosal tumor and right adrenal tumor, incidentally found by ultrasound examination. Computed tomography showed a mass with a diameter of 6 cm adjacent to the stomach and the right adrenal tumor with a diameter of 3 cm. These tumors had similar characteristics in both plain and enhanced imagings. By magnetic resonance imaging, the intensity of the right adrenal tumor was equivalent to the liver in both T1 and T2 weighted images. On the other hand, the gastric submucosal tumor showed low intensity in T1 weighted images and high intensity in T2 weighted images. An adosterol scintigram showed slight accumulation at the region of adrenal tumor. The results of all conducted serum and urinary hormonal examinations were found to be within the normal range. Adrenalectomy and partial gastrectomy were performed laparoscopically. Pathological diagnosis of the adrenal tumor was a cortical adenoma, and that of the gastric submucosal tumor was gastrointestinal stromal tumor (GIST). The gastric tumor was immunohistochemically stained positive with the C-kit and CD34 and negative for s-100 protein and desmin. Histopathological diagnosis was coincident with gastric GIST and right adrenocortical adenoma, and the GIST was diagnosed as a high risk tumor because its diameter was over 5 cm.     

A case of non-functioning adrenocortical adenoma associated with renal cell carcinoma

Left renal and left adrenal masses were incidentally found by computerized tomography (CT) in a 56-year-old man who was admitted to our hospital for treatment of upper digestive tract hemorrhage. Apparently no clinical signs suggestive of Cushing's syndrome existed. The renal tumor was diagnosed as renal cell carcinoma based on the findings on enhanced CT. 131I-adosterol uptake in the examination of adrenal scintigraphy under dexamethasone suppression was definitely increased in the left adrenal gland, although hormonal examinations of serum and urine for adrenal functions were within the normal range. Plasma adrenocorticotropic hormone (ACTH) and serum cortisol were suppressed by administration of 2 mg dexamethasone for 2 days. The left kidney was radically removed by surgery together with the left adrenal gland. Histological diagnoses were left renal cell carcinoma and adrenocortical adenoma.     

肾上腺功能性色素性皮质腺瘤1例报告并文献复习

目的：探讨肾上腺功能性色素性皮质腺瘤的临床及病理学特征。方法：回顾性分析1例肾上腺功能性色素性皮质腺瘤患者的诊治情况,并复习有关文献探讨其临床特征。结果：肾上腺功能性色素性皮质腺瘤临床上十分罕见,无特异性表现,影像学检查提示有肾上腺腺瘤病变,病理检查可见肿瘤细胞胞质内有特异性脂褐质存在。结论：肾上腺功能性色素性皮质腺瘤的诊断主要依靠病理检查,治疗以手术为主。     

A maternal functioning adrenocortical adenoma causing fetal female pseudohermaphroditism

Fetal virilization induced by a maternal adrenal tumor is extremely rare. We report a case of a maternal adrenocortical tumor with Cushing's syndrome causing fetal virilization.     

肾上腺皮质增生及腺瘤中伴贿质嗜铬细胞增生的研究

目的 研究肾上腺皮质增生及腺瘤中是否伴髓质嗜铬细胞的增生。方法 用嗜铬颗粒蛋白Ａ的单克隆抗体,采用免疫组化方法标记嗜铬细胞。结果 ５２例肾上腺皮质增生及腺瘤的病变组织中。３例伴嗜铬细胞增生,５例伴嗜铬细胞微腺瘤形成。此８９例患者中有６例表现为醛固酮－儿茶酚胺增多综合征。结论 肾上腺皮质增生及腺瘤的患者,少数可伴髓质嗜铬细胞的增生或微腺瘤形成,同时可出现皮质醇醛固酮－儿茶酚胺联合增高的症状。     

Nonfunctioning adrenocortical adenoma: a report of two cases

Two cases of nonfunctioning adrenocortical adenoma are herein reported. The adrenal tumor was found incidentally by computed tomography in both patients. Preoperative evaluation revealed that both patients had neither abnormal values in a variety of adrenal function studies nor any recognizable clinical signs associated with adrenal tumor. Following a definitive diagnosis of nonfunctioning adrenal tumors, surgical extirpation was performed in both cases. Histopathological finding was adrenocortical adenoma. Nonfunctioning adrenocortical tumor will be found more frequently with the increasing use of computed tomography in ordinary clinical practice. The management of nonfunctioning adrenocortical tumor is briefly discussed.     

Aldosterone-producing adrenocortical adenoma in childhood: a case report

Aldosterone-producing adrenal tumor is an exceptional cause of hypertension in childhood. The authors describe an 11-year-old girl with hypertension and lower limb weakness who had hyperaldosteronism and left adrenocortical adenoma.     

黏液样肾上腺皮质腺瘤一例报告及文献复习

目的 探讨黏液样肾上腺皮质腺瘤的临床病理特点及治疗方法.方法 分析1例黏液样肾上腺皮质腺瘤患者的临床资料,总结其临床表现、影像学特点、病理学结果及治疗方法,结合文献复习讨论.患者,女,43岁.主诉反复发作头痛、乏力10年,伴高血压、低血钾症.B超提示左肾上腺4.1 crux 3.4 cm低回声实性占位,CT提示肾上腺内2.5 cm×3.8 cm×4.0 cm肿物,CT值24HU,增强后瘤体外周CT值41 HU,中心未见明显强化.结果 患者行腹腔镜下手术,完整切除肿瘤及同侧肾上腺.病理报告:肿物灰粉灰红色相间,质地较硬.肿物剖面呈灰粉灰黄相间的胶冻样物,可见散在出血点.镜下肿瘤细胞大小一致,细胞境界清楚,核膜及核仁无明显异型性,未见核分裂象.肿瘤细胞内可见黏液样物质,部分区域可见细胞周围黏液样基质.免疫组织化学及特殊染色结果:波形纤维蛋白(+)、黑色素蛋白一A(+),阿尔辛蓝/对氨基水杨酸染色(+).病理诊断:黏液样肾上腺皮质腺瘤.术后患者血压及血钾等各项生化指标恢复正常,随访6个月未见肿瘤复发.结论 黏液样肾上腺皮质腺瘤是少见的肾上腺皮质肿瘤,确诊需依靠病理学检查,手术切除肿瘤及同侧肾上腺为首选治疗.