-
Journal of Veterinary Emergency and... Mar 2022(1) To report an unusual etiology for nontraumatic hemoabdomen in cats, and (2) to describe onset and recovery from severe, unexpected pancytopenia seen after surgical...
OBJECTIVE
(1) To report an unusual etiology for nontraumatic hemoabdomen in cats, and (2) to describe onset and recovery from severe, unexpected pancytopenia seen after surgical removal of a large intra-abdominal myelolipoma.
CASE SUMMARY
A 14-year-old neutered male domestic shorthair cat was presented for emergent treatment of suspected nontraumatic hemoabdomen. A hyperechoic mass, with ultrasonographic echogenicity similar to fat, was found in the right cranial abdomen and believed to be associated with the mesentery. Cytological examination of abdominal fluid identified marked extramedullary hematopoiesis within the hemorrhagic effusion. Exploratory laparotomy identified a hepatic mass, which was resected, and revealed to be a hepatic myelolipoma on histopathological examination. The patient's initial recovery was uneventful. However, continued hyporexia resulted in readmission 4 days postoperatively, at which time the patient was found to have a profound, tri-lineage pancytopenia, and cytological evidence indicative of bone marrow recovery. The pancytopenia resolved with continued medical management and supportive care.
NEW OR UNIQUE INFORMATION PROVIDED
Ruptured myelolipoma is not a commonly considered differential for nontraumatic hemoabdomen in cats. Furthermore, severe pancytopenia is unexpected following surgical resection of a myelolipoma. This case provides a unique clinical presentation of both nontraumatic hemoabdomen and bone marrow recovery.
Topics: Abdomen; Adrenal Gland Neoplasms; Animals; Cat Diseases; Cats; Hemoperitoneum; Male; Myelolipoma; Pancytopenia
PubMed: 34766713
DOI: 10.1111/vec.13157 -
Radiology Case Reports Feb 2021Ganglioneuromas are rare tumors that occur spontaneously or arise from a poorly differentiated neuroblastic tumor. Although they are typically described in the pediatric...
Ganglioneuromas are rare tumors that occur spontaneously or arise from a poorly differentiated neuroblastic tumor. Although they are typically described in the pediatric population, they can occur in adults. Ganglioneuromas are often discovered incidentally and their typical imaging appearance, although non-specific, is that of a well-defined solid mass. We are presenting a case of a fat-containing adrenal lesion in a 53-year-old male. The extensive lipomatous changes within the lesion led to the presumption that it represented an adrenal myelolipoma. Pathology revealed a ganglioneuroma with extensive lipomatous changes. This is an uncommon presentation of an adrenal ganglioneuroma mimicking an adrenal myelolipoma. The diagnosis of an adrenal ganglioneuroma raises the possibility of syndromic associations for which patients may undergo genetic testing. We provide a review of typical imaging features of an adrenal ganglioneuroma and provide insight into the situations in which a ganglioneuroma can be suggested as a diagnostic consideration.
PubMed: 33354270
DOI: 10.1016/j.radcr.2020.11.046 -
Polish Archives of Internal Medicine Jan 2023
Topics: Humans; Myelolipoma; Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Mixed Function Oxygenases
PubMed: 36382926
DOI: 10.20452/pamw.16369 -
Saudi Journal of Biological Sciences Mar 2023To determine the nature of adrenal pathology in patients undergoing adrenalectomy in Saudi Arabia over the last decade and compare it with the literature. We compared...
OBJECTIVE
To determine the nature of adrenal pathology in patients undergoing adrenalectomy in Saudi Arabia over the last decade and compare it with the literature. We compared perioperative outcomes between minimally invasive adrenalectomy (MIA) and open adrenalectomy (OA).
METHODS
This retrospective study included patients who underwent adrenalectomy at five tertiary care centers in Saudi Arabia from 2010 to 2020. We collected patients' baseline and perioperative characteristics and detailed hormonal evaluation of adrenal masses.
RESULTS
Among 160 patients (mean age 44 ± 14.5 years; mean BMI 29.17 ± 5.96 kg/m), 84 (51.5 %) were men and 51.5 % had left-sided adrenal masses. The mean tumor size was 6.1 ± 4.2 (1.0-19.5) cm, including 60 (37.5 %) incidentalomas and 65 (40.6 %) functioning masses. Histopathology revealed 74 (46.2 %) adenomas and 24 (15 %) cancers or metastases from other primary organs; 20 %, 8.8 %, and 2.5 % of patients had pheochromocytoma, myelolipoma, and 2.5 % ganglioneuroblastoma, respectively. MIA and OA were performed in 135 (84.4 %) and 21 (15.6 %) patients, respectively. Adrenalectomy was increasingly performed over three equal periods in the last decade (17.5 % vs 34.4 % vs 48.1 %), with increasing numbers of MIAs to replace OAs. OA patients had larger tumors and needed blood transfusion more frequently (47.6 % vs 10.8 %, p< 0.001). MIA was significantly associated with shorter operative time, shorter length of stay, and less blood loss. Postoperative complications occurred in 10 (6.2 %) patients and were significantly higher for OA (24 % vs 3.0 %, p< 0.001).
CONCLUSIONS
The majority of adrenal masses are benign. Herein, the observed functional and perioperative outcomes were comparable to those of available -analyses.
PubMed: 36844643
DOI: 10.1016/j.sjbs.2023.103575 -
Journal of Zoo and Wildlife Medicine :... Jun 2021This retrospective study of neoplasia in nondomestic felids in human care presents the cases diagnosed at Northwest ZooPath (NWZP), Monroe, Washington, from 1998 to 2017... (Review)
Review
This retrospective study of neoplasia in nondomestic felids in human care presents the cases diagnosed at Northwest ZooPath (NWZP), Monroe, Washington, from 1998 to 2017 in conjunction with a scoping literature review. The 554 neoplasms identified in 20 species in the NWZP archive were combined with the 984 neoplasms identified in those same species in the published literature. Some of the cases identified in the literature were from the NWZP archive. Based on this review, mammary adenocarcinoma (183/1,483, 12.3%), lymphoma (89/1,483, 6.0%), squamous cell carcinoma (85/1,483, 5.7%), pheochromocytoma (57/1,483, 3.8%), and thyroid adenoma (57/1,483, 3.8%) are the most frequently reported neoplasms in nondomestic felids in human care. Apparent species predilections for neoplasia include mammary adenocarcinoma in tigers, jaguars, lions, and jungle cats; lymphoma in lions and tigers; squamous cell carcinoma in snow leopards; pheochromocytoma in clouded leopards; ovarian adenocarcinoma in jaguars; cholangiocarcinoma in lions and tigers; multiple myeloma in tigers; bronchoalveolar adenocarcinoma in cougars and lions; hemangiosarcoma, hepatocellular carcinoma, and gastrointestinal adenocarcinoma in lions; mesothelioma in clouded leopards, lions, and tigers; myelolipoma and cutaneous mast cell tumor in cheetahs; soft tissue sarcomas in tigers; and transitional cell carcinoma of the urinary bladder in fishing cats.
Topics: Animals; Animals, Zoo; Felidae; Neoplasms; Retrospective Studies; Species Specificity
PubMed: 34130383
DOI: 10.1638/2020-0077 -
Journal of Vascular and Interventional... Jun 2020
Topics: Adrenal Gland Neoplasms; Adrenal Glands; Angiomyolipoma; Diagnosis, Differential; Female; Fused Kidney; Humans; Incidental Findings; Kidney Neoplasms; Middle Aged; Predictive Value of Tests; Tomography, X-Ray Computed; Ultrasonography
PubMed: 32444111
DOI: 10.1016/j.jvir.2019.12.004 -
The Annals of Thoracic Surgery Nov 2018Myelolipoma is an uncommon benign mesenchymal tumor consisting of mature adipocytes and hemopoietic elements that is mostly found in adrenal glands. Bilateral posterior...
Myelolipoma is an uncommon benign mesenchymal tumor consisting of mature adipocytes and hemopoietic elements that is mostly found in adrenal glands. Bilateral posterior mediastinal primary myelolipoma manifests extremely rarely, and only 11 such occurrences have been previously described. With no definite symptoms, pathologic evaluation is essential for diagnosis. This report presents a case of a 63-year-old man with a diagnosis of bilateral posterior mediastinal primary myelolipoma on the basis of radiologic findings who underwent surgical resection by video-assisted thoracic surgery. The aims of this report are to show the diagnosis of an unusual mediastinal lesion and improve understanding of this disease.
Topics: Adrenal Gland Neoplasms; Biopsy, Needle; Follow-Up Studies; Humans; Immunohistochemistry; Male; Mediastinal Neoplasms; Middle Aged; Minimally Invasive Surgical Procedures; Myelolipoma; Rare Diseases; Risk Assessment; Thoracic Surgery, Video-Assisted; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 29750932
DOI: 10.1016/j.athoracsur.2018.04.013 -
Der Radiologe Jan 2018Benign mesenchymal tumors of the abdomen are-except for hemangiomas-rare neoplasms that are associated with potentially life-threatening complications. Thus, awareness... (Review)
Review
BACKGROUND
Benign mesenchymal tumors of the abdomen are-except for hemangiomas-rare neoplasms that are associated with potentially life-threatening complications. Thus, awareness of the most important entities and knowledge of their imaging characteristics is fundamental for the radiologist.
OBJECTIVES
An overview of the most frequent benign abdominal soft tissue tumors and their common imaging features is given. Furthermore, other facts concerning the individual entities that are relevant to radiologic practice are outlined.
MATERIALS AND METHODS
A literature search and evaluation of the institutional image database were performed.
RESULTS
Hemangiomas, desmoid tumors, lipomas and lipoma variants are presented. Typical characteristics and radiological signs (e. g., iris diaphragm sign, band sign, India ink artifact) are elucidated and illustrated by image examples.
CONCLUSION
Despite the lack of distinctive imaging features, there are a few radiological characteristics suggestive for each of the entities that in many cases allow for correct diagnosis. In cases of doubt, biopsy or surgery is necessary to distinguish them from malignancies.
Topics: Abdomen; Biopsy; Cysts; Humans; Lipoma; Radiography; Soft Tissue Neoplasms
PubMed: 29318350
DOI: 10.1007/s00117-017-0338-4 -
Indian Journal of Pathology &... 2022Adrenal myelolipoma is a benign tumor-like growth, composed of mature fat cells and bone marrow elements. We report a case of a 44-year lady who presented with a...
Adrenal myelolipoma is a benign tumor-like growth, composed of mature fat cells and bone marrow elements. We report a case of a 44-year lady who presented with a complaint of pain in the abdomen. The only positive finding was contrast-enhanced computed tomography (CECT) whole abdomen, which was suggestive of heterogeneously enhancing hypodense lesion of size 130 mm × 105 mm with few calcifications and 103 mm × 75 mm with intralesional fat attenuation in right and left adrenals. Rest laboratory parameters were normal. Only a few cases so far have been reported for bilateral adrenal myelolipoma but what stands out in our case is its giant size and bilaterality, managed surgically without any complications.
Topics: Adrenal Gland Neoplasms; Adrenal Glands; Humans; Lipoma; Myelolipoma; Tomography, X-Ray Computed
PubMed: 35900504
DOI: 10.4103/ijpm.ijpm_182_21 -
Gland Surgery Dec 2020The purpose of this pictorial essay is to review the imaging findings of adrenal lesions. Adrenal lesions could be divided into functioning or non-functioning masses,... (Review)
Review
The purpose of this pictorial essay is to review the imaging findings of adrenal lesions. Adrenal lesions could be divided into functioning or non-functioning masses, primary or metastatic, and benign or malignant. Imaging techniques have undergone significant advances in recent years. The most significant objective of adrenal imaging is represented by the detection and, when possible, characterization of adrenal lesions in order to direct patient management correctly. The detection and management of adrenal lesions is based on cross-sectional imaging obtained with non-contrast CT (tumour density), contrast-enhanced CT including delayed washout (either absolute percentage washout or relative percentage one) and finally with MR chemical shift analysis (loss of signal intensity between in-phase and out-of-phase images including both qualitative and quantitative estimates of signal loss). The small incidental adrenal nodules are benign, in most of cases; some tumors such as lipid-rich adenoma and myelolipoma have characteristic features that can be diagnosed accurately in CT. On contrary, if the presenting contrast-enhanced CT shows an adrenal mass with uncertain or malignant morphologic features, particularly in patients with a known history of malignancy, further evaluations should be considered. The most significative implications for radiologists are represented by how to assess risk of malignancy on imaging and what follow-up to indicate if an adrenal incidentaloma is not surgically removed.
PubMed: 33447584
DOI: 10.21037/gs-20-559