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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 61-year-old male was admitted to our hospital with a complaint of epigastric discomfort and back pain. Chronic pancreatitis was suspected after an abdominal US study. Therefore, an ERCP study was performed. Macroscopically, the papilla of Vater showed an irregular shaped swelling. An ERCP X-ray revealed no abnormal findings, but biopsied specimens from the papilla showed a well differentiated adenocarcinoma in the adenoma, so that a pancreatoduodenectomy was performed. The lesion was 15 x 9 x 6 mm in size, and a histological examination revealed that a minor portion of the tumor was a carcinoma while the major portion was an adenoma, and the invasion as being d0 panc0 n0.
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PMID:[An early cancer in adenoma of the papilla of Vater]. 225 Mar 71

A 41-year-old man with acromegaly was suffering from chronic, progressive backache and aware of reduction in his body height. Endocrine studies revealed increased glucose non-suppressible serum growth hormone (GH) and serum prolactin (PRL). Pituitary microadenoma was detected by a computerized axial tomogram and subsequently resected by trans-sphenoidal adenomectomy. The tumor proved to be a mixed GH- and PRL-secreting adenoma by electron microscopy and immunoperoxidase staining. Concurrent investigation of backache and reduced height disclosed markedly reduced radiodensity of the spinal bones, bilateral nephrocalcinosis, and hypercalciuria, which were ascribed to renal tubular acidosis (RTA) demonstrated by reduced urinary excretion of acids and insufficient reduction of urinary pH following oral administration of ammonium chloride. From the analogy to certain endocrinopathies, it appears likely that enhanced calcium metabolism and resultant hypercalciuria due to excess GH and PRL have led to the development of RTA, which further enhanced calciuria. Such enhanced calcium metabolism and consequent hypercalicuria conceivably led to accelerated demineralization of the spine and resulted in the reduced height of this patient in his early forties.
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PMID:A case of active acromegaly with reduced height and type 1 renal tubular acidosis. 289 4

MRI is synonymous with proton imaging. It provides detailed images of gross anatomy and pathology owing to the excellent soft-tissue contrast, signal void of flowing blood, versatile geometry, and freedom from streak artifacts, as well as other advantages summarized in Table 8-2. In the CNS, MRI has emerged as the most sensitive imaging modality in virtually all pathologies--some reservations remaining concerning acute hemorrhage, focal calcifications, and bone detail. Hence, it should be considered the premier noninvasive examination in the evaluation of the cancer patient with any suspicion of CNS pathology. Economics and availability must, of course, be considered when evaluating MR's role relative to CT. MR clearly provides the best means of excluding pathology, particularly in the posterior fossa, and must be considered after a negative CT examination with persistent clinical suspicions. MRI must also be considered in routine surveillance, if the earliest possible detection of metastasis, demyelination, and other pathologies is to be achieved. MRI should be considered in the evaluation of vertebral metastases, spinal cord compression, and back pain because of its ability to depict CSF, spinal cord, disk, and vertebral body as distinct structures and its sensitivity to marrow disease. In the extremities and pelvis, clearer depiction of soft tissues, vessels, and marrow is a proven advantage. Hence, MRI is indicated in the evaluation of prostate/bladder/rectal carcinoma, uterine/cervical carcinoma, soft tissues/bony sarcomas, and bone metastasis/infarction. In the abdomen, MRI's display of the retroperitoneum and sensitivity to liver lesions indicates its use in the evaluation and staging of renal/adrenal carcinoma, retroperitoneal sarcomas, primary liver tumors, and metastases. Moreover, MRI is also indicated in the evaluation of liver or adrenal masses of uncertain histology owing to a limited specificity of the MR signal for adenoma, carcinoma, and hemangioma. In the chest, MRI's advantages are currently limited owing to the excellent quality of CT images of mediastinum and lung parenchyma and the deleterious effects of respiratory motion. MRI's primary indications in the chest are for the distinction of mediastinal and hilar masses from vessels and aneurysms; evaluation of lumenal patency and superior vena cava syndrome; detection and display of pericardial effusion and the relationship of tumor to the pericardium; and evaluation of internal cardiac anatomy, thrombi, and tumor. Because of rapid technological advances, statements concerning MRI's limitations must be guarded.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Nuclear magnetic resonance imaging in oncology. 333 79

Duplications of gastrointestinal tract are unusual anomalies, especially in the colon. We report a case with two colonic duplications in a 20 year old woman who complained of recurrent backache associated with left lower quadrant abdominal pain. Neither physical examination nor laboratory test alterations were detected. Roentgenographic examination showed organic scolinosis, no intestinal gas and a mass with central hyperdensity and thickened wall in the descending colon area on the CT scan. Laparotomy was performed in which 22 cm of ascending colon and terminal ileum sited on left side, was excised. Pathological study revealed two unrelated and cystic duplications without communication to intestinal lumen. Their epithelial lining were of colonic or gastric types and showed a mucinous adenoma; the remaining layers were normal except for eosinophilic inflammatory infiltrate with Charcot-Leyden like crystaloids. In conclusion, we present a double spherical colonic duplication type I associated to a mucinous adenoma on a non-rotational ascending colon in a patient with organic scoliosis.
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PMID:Double duplication in a nonrotational colon. Study of a case associated with mucinous adenoma. 747 60

The development of renal cell neoplasms ranging from adenoma to metastatic carcinoma is the most serious complication of acquired cystic kidney disease (ACKD). A comprehensive review of the pertinent literature shows that there is up to 50-fold increased risk of renal cell carcinoma in ACKD compared to the general population. The ACKD-associated renal cell carcinoma is seen predominantly in males, occurs approximately 20 years earlier than in the general population, and is frequently bilateral (9%) and multicentric (50%). Acquired cystic kidney disease-associated renal cell carcinoma is frequently asymptomatic (86%), but may be associated with bleeding, abrupt changes in hematocrit, fever, and flank pain or rarely with hypoglycemia, hypercalcemia, or metastases at presentation. Computed tomography seems to provide a better diagnostic yield than sonography or magnetic resonance imaging; nevertheless, large (up to 8 cm) tumors not visualized by any imaging techniques have been reported. It is generally agreed that there is a need for regular screening of symptomatic ACKD patients for early detection of renal cell carcinoma; however, whether screening is needed for asymptomatic patients remains controversial. Nephrectomy is indicated for tumors larger than 3 cm. Management for tumors smaller than 3 cm with persistent symptoms, such as back pain or hematuria, remains controversial, but nephrectomy may be recommended since many of these tumors turn out to be unequivocal renal cell carcinoma. Asymptomatic tumors smaller than 3 cm should be serially screened, and tumor enlargement may be an indication for nephrectomy. Acquired cystic kidney disease-associated renal cell carcinoma accounts for approximately 2% of deaths in renal transplant patients. A median length of survival of approximately 14 months and a 5-year survival rate of 35% are comparable to the same data for renal cell carcinoma in the general population. Successful renal transplant probably decreases the risk of renal cell carcinoma in ACKD patients, but this preliminary observation needs confirmation. The development of ACKD-associated renal carcinoma is a continuous process with evolving phenotypic expression, including damaged renal tubule, simple cyst, cyst with atypical lining, adenoma, and, finally, carcinoma. The pathogenesis of this continuous process is not entirely known, but growth factor-induced compensatory growth of tubular epithelium initiated by the changes of end-stage kidney disease, and probably perpetuated by activation of proto-oncogenes, seems to be the most significant factor.
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PMID:Renal neoplasm in acquired cystic kidney disease. 761 Dec 40

We thoracoscopically managed parathyroid adenoma of the upper anterior mediastinum in a 29-year-old man. He had a backache and was found to have bilateral ureteric stones, hypercalcemia, and extremely increased parathyroid hormone levels. 99mTc-methoxyisobutyl isonitrile scintigraphy showed an accumulation area projected onto the right thyroid lobe and the upper mediastinum. A diagnosis of primary hyperparathyroidism secondary to double adenomas was made. The patient then underwent surgical intervention. With the patient under general anesthesia with one-lung ventilation, a reddish brown adenoma of an upper mediastinum was removed thoracoscopically with three trocars, whereas the right superior parathyroid adenoma was excised by a standard open cervical procedure. Conventionally, the mediastinal parathyroid adenoma was removed by an open approach and was associated with perioperative distress to the patient. If the exact location of the mediastinal lesion is established, thoracoscopic excision of these lesions is feasible and is strongly recommended.
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PMID:Thoracoscopically managed parathyroid adenoma in the upper anterior mediastinum. 1182 66

ACTH-independent Cushing's syndrome (CS) usually results from a solitary adrenocortical adenoma. We recently encountered a patient with ACTH-independent CS associated with bilateral adrenal enlargement. The evaluation led us to consider some rare but interesting entities. The patient was a 69 year-old woman who had a 10-15 year history of controlled hypertension, back pain associated with osteoporosis, easy bruising, and truncal obesity. Her medications included conjugated estrogens. Physical examination revealed classical features of CS. She had a raised blue lesion on her buccal mucosa. Plasma cortisol concentrations were elevated at 36 (a.m.) and 38 (p.m.) microg/dL. Urinary free cortisol was normal at baseline (65 microg/24 hours) but failed to suppress adequately in response to the low-dose dexamethasone suppression test (75 microg/24 hours). The plasma ACTH concentration was undetectable. Plasma cortisol concentrations failed to suppress (37 microg/dL) with an 8 mg overnight dexamethasone test. A CT scan of the abdomen revealed bilateral adrenal masses. The possibilities of food-induced CS and primary pigmented nodular adrenal disease were excluded by a lack of marked stimulation in cortisol secretion to a mixed-meal and dermatologic confirmation of the buccal mucosa lesion as an angioma and not a blue nevus. Adrenal venous sampling showed cortisol secretion from both adrenals. The patient underwent bilateral adrenalectomy with pathology confirming bilateral adenomas. This case illustrates an unusual application of selective venous sampling in the CS evaluation and raises questions about the pathogenesis of cortisol-secreting adrenocortical adenomas.
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PMID:Acth-independent Cushing's syndrome: bilateral cortisol-producing adrenal adenomas. 1525 98

A 34-year-old man was admitted to our hospital with the chief complaints of back pain and epigastralgia. The physical examinations on admission disclosed no abdominal tumor. The serum concentration of total bilirubin was 1.4 mg/dl. The serum elastase-1 level was elevated to 526 ng/dl. Computed tomography showed a cystic lesion, 1 cm in diameter, in the head of the pancreas, without dilatation of the main pancreatic duct. Endoscopic retrograde cholangiopancreatography via the papilla of Vater and the accessory papilla revealed an enlarged ventral pancreatic duct and pancreas divisum. The preoperative diagnosis was mucin-producing pancreatic tumor in the ventral pancreas of a patient with pancreas divisum. A pylorus-preserving pancreatoduodenectomy was performed. The gross findings of the cut surface of the resected specimen disclosed mural nodules in the dilated duct of the ventral pancreas. A histological examination of the mural nodules in the ventral pancreas revealed mucin and intraductal papillary adenoma. Benign tumors associated with pancreas divisum are rare; to the best of our knowledge, only three cases have been reported. Although in these three patients the tumor developed in the dorsal pancreas, the tumor developed in the ventral pancreas in our patient.
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PMID:Intraductal papillary-mucinous adenoma developed in the ventral pancreas in a patient with pancreas divisum. 1554 40

A 56-year-old Japanese man was referred for examination of right adrenal tumor (3 cm). He had no apparent preexisting cancer by radiological workup and accordingly, the patient was considered as a nonfunctioning adrenocortical adenoma and scheduled for periodic CT scans every 6 months. However, five months after the initial diagnosis the patient complained of severe right back pain with remarkable enlargement of both adrenals (~20-fold volume). Although the origin of adrenal tumor was uncertain by pathological workup, positron emission tomography (PET) scan with (18)F-2-fluoro-D-deoxyglucose (FDG) eventually revealed a hot spot on left upper lung, which was consistent with a lesion of thickened bulla wall observed by chest CT. The present case is a very rare example of abrupt enlargement of bilateral adrenals due to clinically isolated adrenal metastasis, suggesting the requirement of frequent observation with greatest care regarding morphologic changes of adrenal incidentalomas.
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PMID:Abrupt enlargement of adrenal incidentaloma: a case of isolated adrenal metastasis. 1787 8

Hepatic adenoma is a benign liver tumor that occurs primarily in women. Complete resection of the adenoma is the standard therapy. The authors present an unusual case report of a histologically proven benign hepatic adenoma occurring in an adolescent boy treated with percutaneous radiofrequency ablation (RFA). A 13-year-old adolescent boy presenting with complaints of back pain was incidentally found to have a 3.5 x 2.5-cm solitary hyperechoic region in the liver on ultrasound. Magnetic resonance imaging scan revealed a lobular solid mass in the posterior segment of the right lobe of the liver that did not have the classic appearance of a hemangioma. An ultrasound-guided percutaneous core biopsy of the lesion was performed. Histologic examination revealed a benign liver adenoma. The tumor was treated with RFA by the interventional radiologist. Postprocedure computed tomography scans obtained at 6 weeks, 8 months, and 1 year and magnetic resonance imaging scan obtained 2 years after the procedure showed complete ablation of the tumor with no evidence of tumor recurrence. Traditionally, surgical resection has been the mainstay of therapy for the treatment of benign hepatic adenoma. In selected cases of histologically proven hepatic adenoma, minimally invasive techniques such as RFA can be safely used as an alternative to open surgical resection.
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PMID:Contemporary management of benign hepatic adenoma using percutaneous radiofrequency ablation. 1676 51


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