慢性间质性肾炎肾功能不全伴发甲状旁腺腺瘤一例报告

慢性间质性肾炎肾功能不全伴发甲状旁腺腺瘤一例报告杨军，郑法雷，毕增祺慢性间质性肾炎、肾小管酸中毒、肾功能不全可合并继发性甲旁亢和肾性骨病，但伴发甲状旁腺腺瘤临床非常罕见，现将我院诊治１例报告如下。患者，女性，６３岁，因反复尿频、尿急、排尿不适２０余年...     

Ectopic parathyroid adenoma: a case report

A 69-year-old woman suffered from bilateral renal stones. Laboratory examinations showed primary hyperparathyroidism. Neck exploration including left hemithyroidectomy and partial thymectomy failed to reveal the abnormal parathyroid gland. Localization studies were done for an ectopic parathyroid adenoma. Repeated selective arteriography with digital subtraction technique revealed an ectopic parathyroid adenoma in the upper mediastinum. Computed tomography, ultrasonotomography and selective venous sampling also confirmed this finding. Subsequently, mediastinal exploration with partial sternotomy was performed and the ectopic parathyroid adenoma was removed. We discuss the preoperative localization studies for ectopic parathyroid adenoma.     

Hyperdense renal cyst associated with papillary adenoma: a case report

An abnormal shadow in the chest of a 57-year-old male was detected during a medical checkup and careful investigation revealed a left posterior mediastinal tumor (neurinoma) and a clearly demarcated homogenous mass with dimensions of 16 x 12 mm and computed tomographic (CT) value of 79 H.U. in the superior pole of the right kidney. The content solution was sticky and blackish-green. Neoplastic degenerations of 8 x 4 and 5 x 5 mm were seen in the cyst. Partial nephrectomy, which included the cystic section, was conducted and papillary adenoma was pathologically diagnosed. Nine years after the operation, the patient is alive and neither relapse nor other abnormalities were detected.     

Ectopic renal tissue associated with an undescended testis: a case report

We report a unique case of isolated ectopic renal tissue associated with an undescended testis. The pathological findings are outlined, and the embryology of renal and testicular development is reviewed. A possible explanation for ectopic renal tissue associated with an undescended testis is presented in conjunction with the normal embryology.     

A parathyroid cyst and an adenoma associated with primary hyperparathyroidism: report of a case

A case of a parathyroid cyst associated with an adenoma in a different gland is reported. A 55-year-old female was explored with preoperative diagnosis of primary hyperparathyroidism after endoscopic removal of a right ureteral stone. The operation revealed a cyst, 20 x 10 mm in size at the left lower gland, and a solid tumor, 32 x 12 x 7 mm in size and 1,300 mg in weight in the left upper gland. Histological examination disclosed a parathyroid cyst and an oxyphilic and chief cell adenoma, respectively. Postoperative course was uneventful including normalized serum Ca level. To our knowledge, 59 cases of parathyroid cysts have been reported in the Japanese literature, of which 31 were in the hyperparathyroid status. The most common causes were cystic degeneration of the adenomas. A parathyroid cyst with a concomitant adenoma in a different gland like our case is very rare. This is the first reported case in Japan and the sixth reported case in the world literature.     

Pituitary adenoma associated with neurofibromatosis: case report

A case of pituitary adenoma associated with multiple neurinomas in the central nervous system was presented. A 52-year-old man was referred to us for surgical treatment of an intradural extramedullary cervical cord tumor. He had been operated on for a cauda equina tumor when he was 43 years old, and again for a glossopharyngeal neurinoma at 49 years of age. His brother expired in childhood, and had multiple subcutaneous nodules. The patient had been complaining of left leg pain, left shoulder pain, and hypesthesia of the right leg and foot. Examination showed 6th cervical nerve root sign. MRI revealed a well-circumscribed extramedullary tumor at the C5 level, and, in addition, incidentally showed an intra- and supra-sellar tumor which was isointensity on T1 weighted and high intensity on T2 weighted images. Myelography showed multiple extramedullary tumors in the lumbar region. Endocrinological study revealed an increased serum prolactin level (818.0ng/ml). The patient had neither café au lait spots nor subcutaneous nodules. A neurinoma of C6 root was totally removed and chromophobe pituitary adenoma was partially removed through a transsphenoidal approach. Neurofibromatosis is known to be associated with many kinds of tumors in the central nervous system. They are usually neurinomas, meningiomas or gliomas, and association of pituitary adenomas has been reported in only three cases, one of which being a prolactin secreting adenoma. Coexistence of multiple primary brain tumors has been also reported apart from phakomatosis. The most common combination is association of glioma and meningioma, and it is probably incidental coexistence due to their high frequency.(ABSTRACT TRUNCATED AT 250 WORDS)     

Ectopic pituitary adenoma in the suprasellar cistern: case report

The case of a 56-year-old man with an ectopic pituitary adenoma is reported. Neurological examinations, neurodiagnostic imaging, surgical observation, endocrinological evaluation, histological examination, and immunohistological study demonstrated evidence of ectopic prolactinoma in the suprasellar cistern and the presence of a normal pituitary in the sella turcica. The patient underwent total removal of the suprasellar mass by a pterional approach, leading to a surgical and endocrinological cure.