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Adrenal surgery

Hanane Eddaoualline, Khadija Mazouz, Bouchra Rafiq, Ghizlane El Mghari Tabib, Nawal El Ansari, Rhizlane Belbaraka, Abdelhamid El Omrani, Mouna Khouchani
BACKGROUND: Ewing sarcoma/primitive neuroectodermal tumor is a family of highly malignant proliferation of neuroectodermal origin, most often skeletal, adrenal localization is extremely rare. Only few cases have been reported in the literature. Classical management includes radical surgery with adjuvant chemotherapy or radiotherapy or both. This case report is the only one where recurrence was surgically removed, and it confirms the importance of adjuvant treatment, and the efficacy of neoadjuvant chemotherapy...
March 16, 2018: Journal of Medical Case Reports
Dezső Kelemen, Zoltán Lőcsei, Róbert Papp, Sándor Ferencz, András Vereczkei
CASE PRESENTATION: After neoadjuvant oncological therapy the surgical treatment of distal pancreatic tumour - infiltrating the celiac axis and the stomach - was reported. During the operation resection of the trunc, distal pancreatectomy, splenectomy, total gastrectomy, resection of the left adrenal gland and cholecystectomy were carried out. The patient's clinical course was uneventful, only transient alteration of liver functions was detected. Histological work-up revealed R1 resection, so adjuvant oncological therapy was decided...
March 2018: Magyar Sebészet
Koy Min Chue, Giap Hean Goh, Alfred Wei Chieh Kow
Adrenal pseudocysts are rare entities, which are usually asymptomatic. Large symptomatic adrenal pseudocysts may cause compressive symptoms. The etiology of these cysts is unknown, although the cyst wall is all lined by fibrous tissue, without any epithelial or endothelial lining. We report a case of a 26-year-old lady who presented with a symptomatic right adrenal pseudocyst measuring 7.6 cm in size. Magnetic resonance imaging confirmed the presence of a right retroperitoneal cystic lesion which was hyperintense on T2 sequencing...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Thierry Brue, Vincent Amodru, Frédéric Castinetti
With fewer than 200 reported cases, Cushing's syndrome (CS) in pregnancy remains a diagnostic and therapeutic challenge. In normal pregnancies, misleading signs may be observed such as striae or hypokalemia, while plasma cortisol and urinary free cortisol may rise up to 2-3-fold. While the dexamethasone suppression test is difficult to use, reference values for salivary cortisol appear valid. The predominant cause is adrenal adenoma (sometimes without decreased ACTH), rather than Cushing's disease. There are considerable imaging pitfalls in Cushing's disease...
March 9, 2018: European Journal of Endocrinology
Chrysanthi Aggeli, Alexander M Nixon, Christos Parianos, Georgios Vletsis, Labrini Papanastasiou, Theodora Kounadi, Georgrios Piaditis, Georgios N Zografos
OBJECTIVE: Resection of pheochromocytomas is a challenging procedure due to hemodynamic lability. Our aim was to evaluate surgical outcomes in 67 patients with pheochromocytoma and to validate the role of laparoscopic surgery in the treatment of these tumors. DESIGN: This study is a retrospective review. A total of 68 procedures for pheochromocytoma were performed between June 1997 and February 2017. All patients were investigated and operated on using an established departmental protocol...
October 2017: Hormones: International Journal of Endocrinology and Metabolism
Go Noguchi, Noboru Nakaigawa, Masataka Taguri, Sohgo Tsutsumi, Yoko Saito, Sachi Fukui, Masato Yasui, Takashi Tokita, Taku Mitome, Tomoyuki Tatenuma, Shinnosuke Kuroda, Koichi Abe, Daiki Ueno, Kazuhiro Namura, Susumu Umemoto, Akitoshi Takizawa, Junichi Ohta, Teiichiro Ueki, Takeshi Watanabe, Kazuki Kobayashi, Keiichi Kondo, Takeshi Kishida, Hitomi Kanno, Kazuo Kitami, Takeharu Yamanaka, Masahiro Yao
We investigated time-dependent changes in the relapse features of renal cell carcinoma (RCC) after curative surgery. Between 1985 and 2015, 1398 patients with RCC (1226 clear cell RCC, 89 papillary RCC, and 53 chromophobe RCC) underwent curative surgery at Yokohama City University Hospital and its affiliated hospitals. We retrospectively reviewed the clinicopathologic factors of patients with relapse after surgery. Median follow-up was 56.3 months. Recurrence occurred in 245 patients (217 clear cell RCC, 12 papillary RCC, and 3 chromophobe RCC)...
March 7, 2018: Clinical & Experimental Metastasis
Adele Latina, Massimo Terzolo, Anna Pia, Giuseppe Reimondo, Elena Castellano, Micaela Pellegrino, Giorgio Borretta
Adrenal insufficiency is a potentially life-threatening condition when it occurs acutely, as in adrenal hemorrhage. Generally it is not reversible and requires chronic replacement therapy. Acute intermittent porphyria (AIP) is a rare genetic disease characterized by alterations in heme biosynthesis that result in accumulation of precursors in tissues. A crisis can be triggered by many conditions such as surgery and infections. Symptoms are similar to those of acute hypoadrenalism. Moreover, both conditions are characterized by hyponatremia...
2018: Case Reports in Endocrinology
Fazli Yanik, Yekta Altemur Karamustafaoglu, Yener Yoruk
CONTEXT: Neuroblastoma is the most common extracranial malignant solid tumor that occurs during childhood. It arises from primitive cells and is seen in the adrenal medulla and sympathetic ganglia of the sympathetic nervous system. CASE REPORT: We present a rare case of a 40-year-old man who was diagnosed with the onset of neuroblastoma arising in the mediastinum. He was treated by means of surgical resection in the superior mediastinum after neoadjuvant chemotherapy...
March 5, 2018: São Paulo Medical Journal, Revista Paulista de Medicina
Kuo-How Huang, Chih-Chin Yu, Ya-Hui Hu, Chin-Chen Chang, Chieh-Kai Chan, Shih-Cheng Liao, Yao-Chou Tsai, Shih-Chieh Jeff Chueh, Vin-Cent Wu, Yen-Hung Lin
BACKGROUND/PURPOSE: Even with the increasing recognition of primary aldosteronism (PA) as a cause of refractory hypertension and an issue of public health, the consensus of its optimal surgical or medical treatment in Taiwan has not been reached. Our objective was to develop a clinical practice guideline that is feasible for real-world management of PA patients in Taiwan. METHODS: The Taiwan Society of Aldosteronism (TSA) Task Force recognized the above-mentioned issues and reached this Taiwan PA consensus at its inaugural meeting, in order to provide updated information of internationally acceptable standards, and also to incorporate our local disease characteristics and constraints into PA management...
March 2, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Joshua D Roth, Jessica T Casey, Benjamin M Whittam, William E Bennett, Konrad M Szymanski, Mark P Cain, Richard C Rink
OBJECTIVES: To analyze nationwide information on the timing of surgical procedures, cost of surgery, hospital length of stay following surgery and surgical complications of female genital restoration surgery (FGRS) in females with congenital adrenal hyperplasia (CAH). METHODS: We used the Pediatric Health Information System database to identify patients with CAH who underwent their initial FGRS in 2004-2014. These patients were identified by an ICD-9 diagnosis code for adrenogenital disorders (255...
March 2, 2018: Urology
Elena Roca, Pier Paolo Mattogno, Teresa Porcelli, Luigi Poliani, Francesco Belotti, Alberto Schreiber, Filippo Maffezzoni, Marco Maria Fontanella, Francesco Doglietto
INTRODUCTION: Plurihormonal adenomas (PHA) represent 10-15% of all functioning pituitary adenomas. The most frequent hormonal association is represented by prolactin and growth hormone (GH). AIM: To describe a rare case of functional ACTH and GH microadenoma, together with a systematic literature review on PHA. METHODS: PubMed was searched using the terms "plurihormonal pituitary adenoma", "ACTH, GH pituitary adenoma", and "Acromegaly AND Cushing's disease"...
February 28, 2018: World Neurosurgery
Yutaka Endo, Minoru Kitago, Akira Miyajima, Isao Kurihara, Kaori Kameyama, Masahiro Shinoda, Hiroshi Yagi, Yuta Abe, Taizo Hibi, Chisato Takagi, Yutaka Nakano, Wataru Koizumi, Osamu Itano, Yuko Kitagawa
INTRODUCTION: von Hippel-Lindau disease (vHL disease) is a hereditary disease in which tumors and cysts develop in many organs, in association with central nervous system hemangioblastomas, pheochromocytomas, and pancreatic tumors. We herein report a case of vHL disease (type 2A) associated with bilateral pheochromocytomas, pancreatic neuroendocrine tumors (PNET), and cerebellar hemangioblastomas treated via pancreatectomy after adrenalectomy. CASE PRESENTATION: A 51-year-old woman presented with a cerebellar tumor, bilateral hypernephroma, and pancreatic tumor detected during a medical checkup...
February 16, 2018: International Journal of Surgery Case Reports
Shiro Matsumoto, Yoshinori Hosoya, Alan Kawarai Lefor, Hidenori Haruta, Takashi Ui, Kentaro Kurashina, Shin Saito, Kentaro Ashizawa, Takahiro Sasaki, Joji Kitayama, Naohiro Sata
INTRODUCTION: Black adrenal adenoma (BAA) is a rare, benign adrenal lesion with a black or brown appearance. This is the first report of this lesion in a patient with a synchronous esophageal cancer and highlights the importance of considering a false positive finding on a Positron Emission Tomography (PET) scan, which might otherwise preclude resection. PRESENTATION OF CASE: A 73-year-old male was diagnosed with mid-esophagus carcinoma. Computed tomography scan revealed an enlarged left adrenal gland...
December 7, 2017: International Journal of Surgery Case Reports
Naoki Edo, Takahiro Yamamoto, Satoshi Takahashi, Yamato Mashimo, Koji Morita, Koji Saito, Hiroshi Kondo, Yuko Sasajima, Fukuo Kondo, Hiroko Okinaga, Kazuhisa Tsukamoto, Toshio Ishikawa
Pheochromocytoma rupture is rare, and emergent adrenalectomy is associated with a high mortality. We herein report a patient with pheochromocytoma rupture who was stabilized by transcatheter arterial embolization (TAE) and subsequently underwent elective surgery. A 45-year-old man presented with the sudden onset of left lateral abdominal pain, headache, chest discomfort, high blood pressure, and adrenal hemorrhaging on enhanced abdominal computed tomography. TAE was performed under a provisional diagnosis of pheochromocytoma rupture...
February 28, 2018: Internal Medicine
G Donatini, J L Kraimps, C Caillard, E Mirallie, F Pierre, Loïc De Calan, Hamy Antoine, O Larin, O Tovkay, S Cherenko
BACKGROUND: Pheochromocytoma (PHEO) in pregnancy is a life-threatening condition. Its management is challenging with regards to the timing and type of surgery. METHODS: A retrospective review of the management of ten patients diagnosed with pheochromocytoma during pregnancy was performed. Data were collected on the initial diagnostic workup, symptoms, treatment, and follow-up. RESULTS: PHEO was diagnosed in ten patients who were between the 10th and the 29th weeks of pregnancy...
February 27, 2018: Surgical Endoscopy
Tetsuhito Kigata, Hideshi Shibata
The adrenal gland regulates stress responses by releasing steroid hormones, whose synthesis and secretion are influenced by adrenal blood flow. Adrenalectomy is commonly performed in rabbits to study the function of the adrenal gland. Although knowledge of the arterial supply to the adrenal gland forms the anatomical basis of the surgery, its description in prior studies is incomplete for the rabbit. Therefore, we observed the adrenal arteries in 27 male and 11 female New Zealand White rabbits using the colored latex injection method...
February 27, 2018: Anatomical Science International
Aisha Hasan, Nadeem Iqbal, Muhammad Athar Khawaja, Arzu Yousuf, Afifa Masood, Yashfeen Malik
Adrenal cysts are not common and are most often non-functional and asymptomatic. Most of these cysts are found incidentally. These lesions exhibit a broad histomorphologic spectrum and may vary from benign cysts to malignant cystic neoplasms. Our patient was a 21-year male who presented with abdominal discomfort and epigastric pain and was diagnosed with left adrenal cyst on ultrasound, which was later confirmed by CT scan.
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Erik Nordenström, Anders Bergenfelz, Martin Almquist
INTRODUCTION: Hypoparathyroidism is the most common complication following thyroidectomy. There are few population-based reports on the rate of hypoparathyroidism in children. The incidence of medical treatment of permanent hypoparathyroidism in children is reported using a national registry. METHODS: The study population included patients below 18 years of age undergoing total thyroidectomy reported to the Scandinavian Quality Registry for Thyroid, Parathyroid and Adrenal Surgery 2004-2014...
February 22, 2018: World Journal of Surgery
Xavier Bertagna
One of today's challenges in endocrinology is the treatment of Cushing's disease: Whereas pituitary surgery has the potential to "cure" the patient and restore a completely normal pituitary adrenal axis, there are immediate failures and late recurrences that will ultimately require alternate therapeutic approaches. Their high number is in direct correlation with their serious limitations and they all appear to be "default options". This "personal view" tries to shed some light on the inescapable difficulties of the current treatments of Cushing's disease, and to provide some optimistic view for the future where the pituitary adenoma should be the "reasonable obsession" of a successful therapeutist…...
February 21, 2018: European Journal of Endocrinology
Gregory Kline, Alexander Leung, Benny So, Alex Chin, Adrian Harvey, Janice L Pasieka
OBJECTIVES: Adrenal vein sampling (AVS) is intended to confirm unilateral forms of primary aldosteronism, which are amenable to surgical cure. Excessively strict AVS criteria to define lateralization may result in many patients incorrectly categorized as bilateral primary aldosteronism and opportunity for surgical cure missed. METHODS: Retrospective review of an AVS-primary aldosteronism database in which surgical cases are verified by standardized outcomes. Having used 'less strict' AVS criteria for lateralization, we examined the distribution of AVS lateralization indices in our confirmed unilateral primary aldosteronism cases both with and without cosyntropin stimulation...
February 20, 2018: Journal of Hypertension
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