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Open Life Sciences 2024The pheochromocytoma is an uncommon endocrine neoplasm that originates from chromaffin cells and causes significant cardiovascular effects through the intermittent or...
The pheochromocytoma is an uncommon endocrine neoplasm that originates from chromaffin cells and causes significant cardiovascular effects through the intermittent or sustained release of catecholamines. In this report, we present a rare case of myocardial infarction (MI) induced by pheochromocytoma. A 53-year-old female presented to the emergency department with a history of intermittent palpitations, back pain, and sweating for over 10 years, which had worsened over the past 2 days. The patient's cardiac enzymes and troponin levels were significantly elevated, and the electrocardiogram (ECG) showed ST-segment elevation, leading to an initial diagnosis of acute myocardial infarction. Echocardiography revealed apical ballooning, indicative of stress cardiomyopathy. Emergency coronary angiography revealed no significant stenosis, and the patient's blood pressure was fluctuating. Computerized tomography (CT) scan of the adrenal gland revealed a bilateral adrenal mass, with the left adrenal mass being larger in size after contrast-enhanced CT scan. The patient's left adrenal gland was successfully removed through laparoscopic adrenalectomy, and histopathology results confirmed the presence of adrenal pheochromocytoma. Follow-up for 3 months after discharge showed the patient had no symptoms and good prognosis. The abnormal findings on echocardiography and ECG resolved. Prompt diagnosis and management of pheochromocytoma are crucial for a favorable prognosis.
PubMed: 38465332
DOI: 10.1515/biol-2022-0830 -
Cureus Feb 2024The latest trend shows a strong demand for minimally invasive surgery. The popularity of robot-assisted surgeries has increased because they eliminate many of the...
The latest trend shows a strong demand for minimally invasive surgery. The popularity of robot-assisted surgeries has increased because they eliminate many of the disadvantages of conventional laparoscopic methods. However, compared to the conventional method of anesthesia treatment, robotic surgery may require adjustments in the way patients are positioned and the general arrangement of personnel and equipment. Pheochromocytomas (PHEOs) are tumours of neural crest cells that make catecholamines. Early detection and appropriate treatment are required for PHEO. The best course of action for treating these tumours is an adrenalectomy. The last several years have seen a considerable advancement in surgical technology with the development of laparoscopic and robotic devices. By comprehending the fundamental elements of robotic surgical systems, anesthesiologists may better manage anesthesia and increase patient safety by being aware of these innovations.
PubMed: 38465083
DOI: 10.7759/cureus.53850 -
Oncology Letters Apr 2024Adrenal cortical eosinophilic adenoma usually presents as non-functional adrenal tumor but may lead to Cushing's syndrome in patients. The present article reports a...
Adrenal cortical eosinophilic adenoma usually presents as non-functional adrenal tumor but may lead to Cushing's syndrome in patients. The present article reports a patient with Cushing's syndrome caused by right adrenocortical oncocytoma. The patient was treated in Urology Department of Wuchuan People's Hospital (Zunyi, China) in November 2022 because of hirsutism, weight gain and hypertension. A laparoscopic right adrenal tumor resection was performed using an abdominal approach. Following surgery, blood pressure and heart rate of the patient fluctuated within a healthy range and menstruation returned to normal. Laparoscopic adrenalectomy has obvious advantages over open adrenalectomy, such as less trauma, shorter recovery time and fewer complications. Thus, this treatment for this rare disease is safe and feasible.
PubMed: 38464335
DOI: 10.3892/ol.2024.14310 -
Journal of Surgical Case Reports Mar 2024Teratoma are germ cell tumors, most frequently arising in and retroperitoneal teratomas are rare, especially adrenal teratomas. Only a few case reports have been...
Teratoma are germ cell tumors, most frequently arising in and retroperitoneal teratomas are rare, especially adrenal teratomas. Only a few case reports have been documented in the literature so far. We report the case of a 52-year-old asymptomatic male patient who had an incidental finding of a left adrenal teratoma during an abdominal computed tomography scan; due to the large size of the tumor, he underwent laparoscopic left adrenalectomy, and histopathological examination revealed a mature teratoma of the left adrenal gland, Patient recovering well after surgery and had no recurrence after 6 months of postoperative follow-up. The preoperative diagnosis of adrenal teratoma is challenging because imaging features are usually non-specific. Minimally invasive surgical resection is the best option for diagnosis and treatment of adrenal teratoma.
PubMed: 38455983
DOI: 10.1093/jscr/rjae100 -
Ugeskrift For Laeger Mar 2024
Topics: Humans; Spleen; Adrenalectomy; Abdomen; Liver; Laparoscopy
PubMed: 38445345
DOI: 10.61409/V72013 -
International Journal of Surgery Case... Mar 2024Myelolipoma, a benign tumor characterized by mature fat cells and hematopoietic cells, is predominantly found in the adrenal glands, accounting for 6-16 % of all...
INTRODUCTION
Myelolipoma, a benign tumor characterized by mature fat cells and hematopoietic cells, is predominantly found in the adrenal glands, accounting for 6-16 % of all adrenal tumors. These tumors are often asymptomatic and discovered incidentally during imaging. We present a rare case of concurrent adrenal and extra-adrenal myelolipomas, contributing to the limited research in this area.
CASE PRESENTATION
A 65-year-old female with a history of Steven-Johnson syndrome presented with epigastric pain, initially diagnosed with emphysematous cholecystitis. Imaging revealed unexpected lesions near the left kidney. During surgery for presumed cholecystitis, significant hemorrhaging occurred following an attempted biopsy of the left adrenal lesion. This complication necessitated a complete adrenalectomy. Pathological examination confirmed the presence of myelolipomas in the left adrenal gland, para-aortic, and left para-iliac regions.
DISCUSSION
The simultaneous occurrence of adrenal and extra-adrenal myelolipomas is exceptionally rare, posing diagnostic and management challenges. This case highlights the complexity of managing patients with multiple comorbidities and the critical importance of differentiating myelolipomas from other fat-containing retroperitoneal masses. The incidental discovery of these tumors and their potential for significant intraoperative complications, as seen in our case, underscores the need for careful surgical planning and thorough preoperative assessment.
CONCLUSION
This case emphasizes the diagnostic challenges and management complexities in patients with incidental findings of myelolipoma, particularly when accompanied by significant medical histories. The occurrence of unexpected intraoperative complications highlights the importance of cautious decision-making in surgical interventions. This report provides valuable insights into the unpredictable nature of medical practice and the management of rare pathologies.
PubMed: 38430892
DOI: 10.1016/j.ijscr.2024.109398 -
Cureus Jan 2024The prevalence of adrenal incidentalomas (i.e., incidental findings) has grown in recent years with the evolution of imaging methods. Adrenal masses can be benign or...
The prevalence of adrenal incidentalomas (i.e., incidental findings) has grown in recent years with the evolution of imaging methods. Adrenal masses can be benign or malignant. Malignant ones are less frequent, but the detection of primary adrenal neoplasms is even less frequent, especially in the case of a diffuse large B-cell lymphoma (DLBCL). This case concerns a 68-year-old man who presented to the emergency department due to fatigue and anorexia. Given his blood test results on admission, he underwent a computed tomography (CT) with angiography that identified a mass in the left adrenal gland with displacement of the ipsilateral kidney. Left tumorectomy, adrenalectomy, and nephrectomy were performed, and the mass corresponded to a nongerminal center-type DLBCL. This case highlights the importance of prompt diagnosis and surgical and pharmacologic treatment of DLBCL.
PubMed: 38425629
DOI: 10.7759/cureus.53231 -
CNS Neuroscience & Therapeutics Feb 2024Glucocorticoids (GCs) are steroidal hormones produced by the adrenal cortex. A physiological-level GCs have a crucial function in maintaining many cognitive processes,...
BACKGROUND
Glucocorticoids (GCs) are steroidal hormones produced by the adrenal cortex. A physiological-level GCs have a crucial function in maintaining many cognitive processes, like cognition, memory, and mood, however, both insufficient and excessive GCs impair these functions. Although this phenomenon could be explained by the U-shape of GC effects, the underlying mechanisms are still not clear. Therefore, understanding the underlying mechanisms of GCs may provide insight into the treatments for cognitive and mood-related disorders.
METHODS
Consecutive administration of corticosterone (CORT, 10 mg/kg, i.g.) proceeded for 28 days to mimic excessive GCs condition. Adrenalectomy (ADX) surgery was performed to ablate endogenous GCs in mice. Microinjection of 1 μL of Ad-mTERT-GFP virus into mouse hippocampus dentate gyrus (DG) and behavioral alterations in mice were observed 4 weeks later.
RESULTS
Different concentrations of GCs were shown to affect the cell growth and development of neural stem cells (NSCs) in a U-shaped manner. The physiological level of GCs (0.01 μM) promoted NSC proliferation in vitro, while the stress level of GCs (10 μM) inhibited it. The glucocorticoid synthesis blocker metyrapone (100 mg/kg, i.p.) and ADX surgery both decreased the quantity and morphological development of doublecortin (DCX)-positive immature cells in the DG. The physiological level of GCs activated mineralocorticoid receptor and then promoted the production of telomerase reverse transcriptase (TERT); in contrast, the stress level of GCs activated glucocorticoid receptor and then reduced the expression of TERT. Overexpression of TERT by AD-mTERT-GFP reversed both chronic stresses- and ADX-induced deficiency of TERT and the proliferation and development of NSCs, chronic stresses-associated depressive symptoms, and ADX-associated learning and memory impairment.
CONCLUSION
The bidirectional regulation of TERT by different GCs concentrations is a key mechanism mediating the U-shape of GC effects in modulation of hippocampal NSCs and associated brain function. Replenishment of TERT could be a common treatment strategy for GC dysfunction-associated diseases.
Topics: Mice; Animals; Glucocorticoids; Hippocampus; Corticosterone; Neural Stem Cells; Memory Disorders
PubMed: 38421107
DOI: 10.1111/cns.14577