Dear Editor,Adrenocortical carcinomas and adrenal cysts,including pseudocysts,are uncommon tumors[1,2].No consistent approach to surgery for large adrenal tumors including cysts,has been established,and especially whe...Dear Editor,Adrenocortical carcinomas and adrenal cysts,including pseudocysts,are uncommon tumors[1,2].No consistent approach to surgery for large adrenal tumors including cysts,has been established,and especially when malignancy is suspected,consideration is still given to the option of laparotomy.Using robot-assisted surgery,we successfully performed the resection of a giant adrenal pseudocyst and a giant adrenocortical carcinoma,as reported previously[3],underlining the advantages of robot-assisted surgery for large adrenal tumors.展开更多
Primary adrenal myelolipoma is a rare, non-functioning adrenal benign tumor that is composed of mature adipose tissue and a variable amount of haemopoietic elements. Clinically, it is difficult to get diagnosed with a...Primary adrenal myelolipoma is a rare, non-functioning adrenal benign tumor that is composed of mature adipose tissue and a variable amount of haemopoietic elements. Clinically, it is difficult to get diagnosed with adrenal myelolipoma because the patient usually doesn't have obvious symptoms and signs in early stage. In the present study, two cases of primary bilateral adrenal myelolipomas are reported. Clinical presentation, imaging diagnostic features, histopathological changes and surgical treatments of the two patients are discussed. Preoperative diagnostic imaging examinations(B-mode ultrasonography, computed tomography and magnetic resonance imaging sans) assisted getting a prediction diagnosis of bilateral adrenal myelolipomas. A two-stage surgery was used to successfully excise bilateral adrenal myelolipomas in the two patients. Conventional open adrenalectomy was applied to remove the adrenal myelolipomas greater than 6 cm, and laparoscopic adrenalectomy was performed to excise the adrenal tumors smaller than 6 cm. Bilateral adrenal myelolipomas of the two patients were finally confirmed by postoperative histopathological examinations. Understanding clinical, imaging diagnostic and histopathological features of bilateral adrenal myelolipomas will facilitate timely diagnosis and treatment of this condition. Surgical removal of bilateral adrenal myelolipomas is safe, curative and beneficial.The two-stage surgery appears to be the best treatment option for the patients with bilateral adrenal myelolipomas because it achieves optimal treatment effectiveness with minimized sequelae.展开更多
Echinococcal cysts are usually found in liver and lungs, but any other organ can potentially be involved. Extrahepatic disease due to hydatid cyst may develop in the abdominal and pelvic cavity, aside from in other le...Echinococcal cysts are usually found in liver and lungs, but any other organ can potentially be involved. Extrahepatic disease due to hydatid cyst may develop in the abdominal and pelvic cavity, aside from in other less common locations, which may make both diagnosis and treatment more complex. We present a rare case of extrahepatic echinococcosis in a 70-year old patient with a 4-d history of dull abdominal pain, anemia within the transfusion range and fever. She underwent surgery for left renal hydatid cysts 30 years ago. After non operative treatment, imaging studies showed a calcified hydatid cyst in a retrogastric location communicating with a proximal jejunal loop. En-block resection of the mass together with the adrenal gland was performed including closure of the enteric fistula. Anatomic pathology confirmed the diagnosis of a calcified hydatid cyst of left adrenal origin. Surgery is the treatment of choice and most authors recommend removal of cyst and adrenal gland.展开更多
Hypothalamic Corticotropin-releasing factor (CRF) directly activates the hypothalamic pituitary adrenal axis (HPA axis) during the surgical trauma induced stress response. Electroacupuncture (EA) has been demonstrated...Hypothalamic Corticotropin-releasing factor (CRF) directly activates the hypothalamic pituitary adrenal axis (HPA axis) during the surgical trauma induced stress response. Electroacupuncture (EA) has been demonstrated to have stress relieving effects in breast surgery, colorectal surgery, prostatectomy and craniotomy. This study was aimed to investigate the hypothesis that EA could regulate hypothalamic CRF in surgical trauma rats. In experiment one, Sprague-Dawley (SD) male rats were divided into intact, model (10% partial hepatectomy), sham EA and EA group. Rats from the Sham EA and EA group were stimulated at ST36-Zusanli and SP6-Sanyiniiao acupoints twice, 24 hours before the surgery and immediately after the surgery. Expressions of hypothalamic CRF and CRFR, GABA receptors, glutamate decarboxylase (GAD), serum adrenocorticotropic hormone (ACTH) and Corticosterone (CORT) were observed at 2, 4, 8 and 24 h after the surgery by radioimmunoassay (RIA), western blot, real-time PCR and immunohistochemistry. In the experiment two, SD male rats were divided into the intact, model, model + vehicle, model + L-838,417 EA and EA + L838,417 group. It was found that hypothalamus CRF, serum ACTH and CORT levels were increased in model group compared with the intact group, and those in the EA group decreased in comparison with the model group. Compared with the model group, hypothalamus-aminobutyric acid (GABA) receptor Aα3 mRNA and protein expressions of the EA group raised strikingly. In conclusion, EA alleviated surgical stress response by improving the GABA synthesis in hypothalamus, thus enhancing GABA receptors’ inhibitory regulation of the HPA axis dysfunction in rats with acute surgical trauma.展开更多
BACKGROUND Metastases to adrenal glands originate principally from lung, breast, or gastrointestinal cancers, followed by malignant melanoma and thyroid neoplasms. We present an unusual case of uterine cancer metastas...BACKGROUND Metastases to adrenal glands originate principally from lung, breast, or gastrointestinal cancers, followed by malignant melanoma and thyroid neoplasms. We present an unusual case of uterine cancer metastasizing to the adrenal glands with a review of the English literature on the management of this rare disease. CASE SUMMARY A 53-year-old Caucasian woman with a history of endometrial cancer (grade 2;International Federation of Gynecology and Obstetrics III A) was hospitalized in November 2017 for a left adrenal mass found on a follow-up computed tomography scan 3 years after her gynecological surgery. Laboratory test results were normal. A laparoscopic left adrenalectomy was performed. The postoperative course was uneventful, and no chemotherapy was administered. The pathological report confirmed an adrenal endometrioid metastasis. At 36 mo of follow-up, the patient is alive and well, with no evidence of recurrent disease. A literature review identified only 11 previously-published cases of adrenal metastases from uterine cancer. CONCLUSION Adrenal metastasis from uterine cancer is very rare. Laparoscopic adrenalectomy may be an effective treatment in selected cases of localized adrenal metastasis.展开更多
Introduction: Cysts of the adrenal gland are rare and are usually discovered incidentally, typically presented with abdominal pain or palpable mass. There are four categories of adrenal gland cyst: epithelial, endothe...Introduction: Cysts of the adrenal gland are rare and are usually discovered incidentally, typically presented with abdominal pain or palpable mass. There are four categories of adrenal gland cyst: epithelial, endothelial, parasitic and pseudocysts. We report the case of a 33-year-old woman who presented as a pain of the right hypochondrium and abdominal distention and was diagnosed with a large unilateral adrenal pseudocyst. Case presentation: A 33-year-old Moroccan woman followed for acute articular rheumatism for 3 years was admitted with left hypochondralgia and abdominal distention. Magnetic resonance imaging. (MRI) and abdominal computed tomography revealed a large left adrenal cyst mass measuring 19 cm. The patient underwent surgery, and the cyst was completely removed. Histological examination revealed an adrenal pseudocyst. Symptoms resolved after pseudocyst removal. Conclusion: Adrenal pseudocysts are uncommon. Symptoms are usually related to the size and local pressure effect of the cysts.展开更多
文摘Dear Editor,Adrenocortical carcinomas and adrenal cysts,including pseudocysts,are uncommon tumors[1,2].No consistent approach to surgery for large adrenal tumors including cysts,has been established,and especially when malignancy is suspected,consideration is still given to the option of laparotomy.Using robot-assisted surgery,we successfully performed the resection of a giant adrenal pseudocyst and a giant adrenocortical carcinoma,as reported previously[3],underlining the advantages of robot-assisted surgery for large adrenal tumors.
文摘Primary adrenal myelolipoma is a rare, non-functioning adrenal benign tumor that is composed of mature adipose tissue and a variable amount of haemopoietic elements. Clinically, it is difficult to get diagnosed with adrenal myelolipoma because the patient usually doesn't have obvious symptoms and signs in early stage. In the present study, two cases of primary bilateral adrenal myelolipomas are reported. Clinical presentation, imaging diagnostic features, histopathological changes and surgical treatments of the two patients are discussed. Preoperative diagnostic imaging examinations(B-mode ultrasonography, computed tomography and magnetic resonance imaging sans) assisted getting a prediction diagnosis of bilateral adrenal myelolipomas. A two-stage surgery was used to successfully excise bilateral adrenal myelolipomas in the two patients. Conventional open adrenalectomy was applied to remove the adrenal myelolipomas greater than 6 cm, and laparoscopic adrenalectomy was performed to excise the adrenal tumors smaller than 6 cm. Bilateral adrenal myelolipomas of the two patients were finally confirmed by postoperative histopathological examinations. Understanding clinical, imaging diagnostic and histopathological features of bilateral adrenal myelolipomas will facilitate timely diagnosis and treatment of this condition. Surgical removal of bilateral adrenal myelolipomas is safe, curative and beneficial.The two-stage surgery appears to be the best treatment option for the patients with bilateral adrenal myelolipomas because it achieves optimal treatment effectiveness with minimized sequelae.
文摘Echinococcal cysts are usually found in liver and lungs, but any other organ can potentially be involved. Extrahepatic disease due to hydatid cyst may develop in the abdominal and pelvic cavity, aside from in other less common locations, which may make both diagnosis and treatment more complex. We present a rare case of extrahepatic echinococcosis in a 70-year old patient with a 4-d history of dull abdominal pain, anemia within the transfusion range and fever. She underwent surgery for left renal hydatid cysts 30 years ago. After non operative treatment, imaging studies showed a calcified hydatid cyst in a retrogastric location communicating with a proximal jejunal loop. En-block resection of the mass together with the adrenal gland was performed including closure of the enteric fistula. Anatomic pathology confirmed the diagnosis of a calcified hydatid cyst of left adrenal origin. Surgery is the treatment of choice and most authors recommend removal of cyst and adrenal gland.
文摘Hypothalamic Corticotropin-releasing factor (CRF) directly activates the hypothalamic pituitary adrenal axis (HPA axis) during the surgical trauma induced stress response. Electroacupuncture (EA) has been demonstrated to have stress relieving effects in breast surgery, colorectal surgery, prostatectomy and craniotomy. This study was aimed to investigate the hypothesis that EA could regulate hypothalamic CRF in surgical trauma rats. In experiment one, Sprague-Dawley (SD) male rats were divided into intact, model (10% partial hepatectomy), sham EA and EA group. Rats from the Sham EA and EA group were stimulated at ST36-Zusanli and SP6-Sanyiniiao acupoints twice, 24 hours before the surgery and immediately after the surgery. Expressions of hypothalamic CRF and CRFR, GABA receptors, glutamate decarboxylase (GAD), serum adrenocorticotropic hormone (ACTH) and Corticosterone (CORT) were observed at 2, 4, 8 and 24 h after the surgery by radioimmunoassay (RIA), western blot, real-time PCR and immunohistochemistry. In the experiment two, SD male rats were divided into the intact, model, model + vehicle, model + L-838,417 EA and EA + L838,417 group. It was found that hypothalamus CRF, serum ACTH and CORT levels were increased in model group compared with the intact group, and those in the EA group decreased in comparison with the model group. Compared with the model group, hypothalamus-aminobutyric acid (GABA) receptor Aα3 mRNA and protein expressions of the EA group raised strikingly. In conclusion, EA alleviated surgical stress response by improving the GABA synthesis in hypothalamus, thus enhancing GABA receptors’ inhibitory regulation of the HPA axis dysfunction in rats with acute surgical trauma.
文摘BACKGROUND Metastases to adrenal glands originate principally from lung, breast, or gastrointestinal cancers, followed by malignant melanoma and thyroid neoplasms. We present an unusual case of uterine cancer metastasizing to the adrenal glands with a review of the English literature on the management of this rare disease. CASE SUMMARY A 53-year-old Caucasian woman with a history of endometrial cancer (grade 2;International Federation of Gynecology and Obstetrics III A) was hospitalized in November 2017 for a left adrenal mass found on a follow-up computed tomography scan 3 years after her gynecological surgery. Laboratory test results were normal. A laparoscopic left adrenalectomy was performed. The postoperative course was uneventful, and no chemotherapy was administered. The pathological report confirmed an adrenal endometrioid metastasis. At 36 mo of follow-up, the patient is alive and well, with no evidence of recurrent disease. A literature review identified only 11 previously-published cases of adrenal metastases from uterine cancer. CONCLUSION Adrenal metastasis from uterine cancer is very rare. Laparoscopic adrenalectomy may be an effective treatment in selected cases of localized adrenal metastasis.
文摘Introduction: Cysts of the adrenal gland are rare and are usually discovered incidentally, typically presented with abdominal pain or palpable mass. There are four categories of adrenal gland cyst: epithelial, endothelial, parasitic and pseudocysts. We report the case of a 33-year-old woman who presented as a pain of the right hypochondrium and abdominal distention and was diagnosed with a large unilateral adrenal pseudocyst. Case presentation: A 33-year-old Moroccan woman followed for acute articular rheumatism for 3 years was admitted with left hypochondralgia and abdominal distention. Magnetic resonance imaging. (MRI) and abdominal computed tomography revealed a large left adrenal cyst mass measuring 19 cm. The patient underwent surgery, and the cyst was completely removed. Histological examination revealed an adrenal pseudocyst. Symptoms resolved after pseudocyst removal. Conclusion: Adrenal pseudocysts are uncommon. Symptoms are usually related to the size and local pressure effect of the cysts.
