Functional and non-functional types of adrenal tumors: a case series (original) (raw)
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Oman Medical Journal, 2015
heochromocytoma is a rare but lifethreatening condition that has varied clinical presentations particularly hypertension, headache, palpitation, and sweating. 1,2 Patients with suggestive clinical features are frequently tested for pheochromocytoma. The medical interest in this tumor has increased with the improved availability of diagnostic laboratory tools particularly plasma or urinary fractionated metanephrines (metanephrine and normetanephrine), and other neuroendocrine markers particularly chromogranin A. 3,4 The wide universal availability of different imaging facilities, both anatomical and functional, has also improved the detection of pheochromocytoma. 5 The growing awareness for implementing different protocols and guidelines that consider pheochromocytoma in the work-up and differential diagnosis has improved diagnosis of the disorder. 6 Accurate diagnosis is important because if the tumor is detected early laparoscopic or surgical treatment is usually curative before other changes or complications take place. Catecholamine-producing tumors are neuroendocrine tumors that affect the chromaffin cells of adrenal medulla and postganglionic fibers of case report
Adrenal Pheochromocytoma -A Case Presentation with Review of Literature
https://www.ijhsr.org/IJHSR\_Vol.12\_Issue.8\_Aug2022/IJHSR-Abstract17.html, 2022
Pheochromocytoma is a rare catecholamine secreting tumor which arises from adrenal medulla and extra-adrenal sites. Its clinical presentation is sustained or intermittent hypertension often with paroxysmal symptoms. Imaging studies and estimation of catecholamines and metanephrine in a 24 hours urine sample helps to arrive at definite diagnosis. Correct diagnosis is very important because resection of tumor dramatically reverses clinical symptoms. We present a case of adrenal pheochromocytoma in a 34-year-old female patient to highlight its rarity, clinical presentation and histopathological features.
Pheochromocytoma and Adrenocortical Adenoma in the Same Gland
Journal of the Chinese Medical Association, 2007
A right adrenal tumor was found incidentally during abdominal computed tomography exam in a 51-year-old female patient, who had had diabetes and hypertension for more than 10 years. The computed tomography scan was arranged for possible pancreatic lesion by a neurologist. Norepinephrine level was high in the plasma and urine. Vanillylmandelic acid level was elevated in the urine. Diurnal cortisol rhythm, plasma adrenocorticotropic hormone and urine free cortisol were all normal, but the plasma cortisol concentration could not be suppressed after a standard low-dose dexamethasone suppression test. Therefore, adrenal cortical adenoma with subclinical Cushing's syndrome was highly suspected; however, further imaging studies, including magnetic resonance image and 131 I-6β-iodomethylnorcholesterol adrenal scintigraphy failed to discriminate an additional tumor. After right adrenalectomy, a small adrenal cortical adenoma and a large pheochromocytoma were noted. This is an extremely rare case of an adrenal incidentaloma consisting of both medullary and cortical tumors in the same gland. [
Incidental adrenal pheochromocytoma – a report on three cases
Sri Lanka Journal of Diabetes Endocrinology and Metabolism, 2013
Incidentally detected adrenal tumours pose a diagnostic challenge to the physician. Although hormonal evaluation is prioritized, it is essential to have a thorough radiological assessment of the tumour properties prior to planning the definitive management. The aim is to report on our experience of 3 patients with an Incidental Adrenal Lesion (IAL) who were found to be hormonally 'normal' but suspicious features on CT imaging lead to surgery, after which histology revealed features of pheochromocytoma with no evidence of metastasis. Peri-operatively all three experienced haemodynamic instability. The discussion in this article mainly emphasizes the importance of CT imaging of adrenals. It also focuses on the histopathological difficulties in predicting the tumour behavior especially in the absence of metastatic deposits.
Uncommon Adrenal Tumors: A Case Series
Journal of Advances in Medicine and Medical Research
Adrenal tumors are very rare. These lesions are called adrenal incidentalomas because they are incidentally detected through imaging procedure. Its prevalence ranges from 1.4% to 2.9% worldwide. Clinical suspicion, laboratory testing, Imaging and histopathological examination needed for definite diagnosis. We report three cases of adrenal tumors received at our institute between the year 2021 and 2022. Pheochromocytoma of Adrenal gland scaled score (PASS) tells about the prognosis based on histopathological findings. Earliest management is essential as these tumors are related with secretion of hormones and may have a poor prognosis.
Adrenal Incidentaloma With the Diagnosis of Normotensive Pheochromocytoma: A Case Report
Disease and Diagnosis
Background: Pheochromocytomas (PCCs) are catecholamine-producing neuroendocrine tumors that originate from the adrenal medulla. Their clinical presentations most commonly include hypertension, headache, palpitations, and sweating; however, PCCs are sometimes normotensive and clinically silent. Case Presentation: A female patient with abdominal pain as well as persistent and crushing left flank pain for the past six months was examined. The imaging studies revealed a mass in the upper pole of the left kidney indicative of a potential adrenal gland tumor; however, she had normal blood pressure (BP). Histopathologic examination of the mass from exploratory laparotomy showed that it was a PCC. Findings from sonography and computed tomography (CT) scan of the left adrenal tumor, along with elevated urinary normetanephrine level and positive iodine-123 metaiodobenzylguanidine (MIBG) scan led to preoperative diagnosis of PCC in our case. Conclusion: This study highlighted the importance of...
The Malaysian journal of medical sciences : MJMS, 2012
Pheochromocytomas are rare tumours originating from the chromaffin tissue. The clinical manifestations are variable and are not specific; as a result, pheochromocytomas often imitate other diseases. The diagnosis is usually established by biochemical studies, i.e., the measurement of catecholamines or their metabolites in urine or plasma, followed by radiographic and scintigraphic studies for localisation. Surgical removal of the tumour is the preferred treatment. We report a 30-year-old woman presenting with an adrenal incidentaloma that was 7.6 × 5.3 × 4.8 cm in size on an abdominal computed tomography scan. Investigations for adrenal hormones, including a low-dose dexamethasone suppression test, plasma aldosterone level, 24-hour urinary metanephrine and vanillylmandelic acid levels, and plasma metanephrine level were all within the normal ranges. During the surgical resection, the patient had a hypertensive spell. Surgery was postponed, and the blood pressure was adequately contr...
Cases Journal, 2008
Introduction: Adrenal incidentaloma can be described as adrenal lesions that are incidentally diagnosed during abdominal laparotomy or any abdominal screening without prior suspicion of adrenal disease. It is important to diagnose adrenal lesions to learn if they are hormonally active or malignant. The most common clinical sign of pheochromocytoma is sustained or paroxysmal hypertension, and the most common symptoms are headache, excessive truncal sweating, and palpitation. In some cases, the clinical symptoms are not clear. Roughly 70% of adrenal incidentalomas are non-functional. A small group of 5-7% of the functional ones (30%) may exist as pheochromocytoma. Ten percent of pheochromocytoma cases are diagnosed incidentally during computed tomography (CT) or magnetic resonance imaging (MRI) screenings for other reasons. The most frequent symptom of the pheochromocytoma is hypertension, and 90-100% of cases exhibit it. The literature indicates that incidental pheochromocytoma cases that are smaller than 1 cm have no clinical symptoms. Rarely, some large pheochromocytoma cases do not show any clinical symptoms, and it is difficult to diagnose very small ones.
The collection of five interesting cases of adrenal tumors from one center
World Journal of Surgical Oncology, 2014
Introduction: Adrenal tumors are detected incidentally in 4 to 8% of patients in imaging studies. Adenomas, pheochromocytomas and adrenocortical carcinomas represent the most common tumors of the adrenal glands. Rarely are final histopathological reports are surprising. Aim: The aim of our study is a retrospective analysis of selected clinical characteristics and hormonal studies in five cases of rare adrenal tumors. Materials and methods: We present five interesting cases of adrenal tumors: two medullary hyperplasia, one adenomatoid tumor, one hydatid cyst and a primary angiosarcoma of the adrenal gland. The final diagnosis was established by means of microscopic examination of the specimens. Conclusions: The number of adrenal tumors was increased due to widespread use of imaging procedures. In patients without any known extra-adrenal malignancy most lesions are benign, non-hyper functioning adenomas. Adrenal tumors should be evaluated biochemically and radiologically.