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

A case of malignant transformation of benign mixed tumor (pleomorphic adenoma) arising from the right lacrimal gland is reported. A 63-year-old man was referred to our clinic because of visual disturbance and protrusion of the right eye in January, 1989. His past history revealed that he had had a benign mixed tumor of the right lacrimal gland resected 19 years ago. On CT scan, an iso-density lesion homogeneously enhanced with contrast medium was found in the right orbit. This tumor was partially cystic and invaded the cranial cavity. On T1 and T2 weighted MRI, the tumor appeared as an iso-intensity area. At surgery, the tumor was subtotally resected via the combined fronto-orbital approach on February 3, 1990. Histological diagnosis of the tumor was squamous cell carcinoma, and it was construed to be a malignant transformation of mixed tumor of the lacrimal gland. Postoperatively he was placed on a course of external radiation therapy (63 Gy in total) in combination with intra-carotid Cisplatin injection therapy. The first sign of the recurrence was seen as multiple metastatic lesions in both lungs about 4 months after the surgery. In December, 1990, protrusion of the left eye and disturbance of ocular movement became progressively worse. On CT scan, recurrent metastatic tumor was seen in the left orbit and paranasal sinuses. Although additional chemotherapy and irradiation brought about a short period of symptomatic relief he succumbed to pneumonia in April 18, 1990. Metastatic squamous cell carcinoma was confirmed in the lung at autopsy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Malignant transformation of benign mixed tumor of lacrimal gland to squamous cell carcinoma 19 years after initial surgery: report of a case]. 131 Aug 2

Within a two and half years period, we collected a total of twenty three cases of adrenal tumors diagnosed by MRI. They included: one cystic case, twelve cases (13 lesions) of adenoma, two cases (3 lesions) of hyperplasia, four cases of pheochromocytoma, three cases of metastases, and one case of adenocarcinoma. Except for the case of adrenal cyst which was followed for one and a half years, all the other twenty two cases were proved by operation and pathology. The benign adenoma and hyperplasia were small in size, and had relative isointensities to the liver in the T1WI and the T2WI. On the contrary, the malignant tumors and pheochromocytoma, all had inhomogeneous signal intensities, showed relatively lower in signal intensities in T1WI and higher in T2WI as compared with the liver. In T2WI, the tumor to liver signal intensity ratio of adenoma and hyperplasia were less than 1.80, whereas the malignant tumors and pheochromocytoma were larger than 1.80. In comparing fifteen cases with Gd-DTPA intravenous injection, all of the benign adenoma did not show an increase in signal intensity, but the malignant tumors and pheochromocytoma showed increase in signal intensity. We concluded that we could primarily differentiate the nature of adrenal tumors by their change in signal intensities between T1WI and T2WI, by measuring the tumor to liver signal intensity ratio or by Gd-DTPA IV injection. Today, although adrenal gland MRI examination is more time consuming and expensive, it is more valuable for highly clinically suspected adrenal lesions with equivocal results after CT or sonogram study.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[MRI of adrenal tumors]. 131 46

In part two of this paper about orbital tumors, neoplasms of the lacrimal gland are discussed: These have to be properly separated from inflammations. While inflammatory affections of the lacrimal gland make up the majority of private practice consultations, in cases referred to an eye clinic the relation between inflammatory diseases and neoplasms is about equal (between 1987 and 1990, 14 neoplasias and 14 inflammations were seen at the University Eye Clinic, Zurich). The benign pleomorphic adenoma of the lacrimal gland should be removed in toto in its capsule. For this procedure a lateral orbital fenestration is required. An excisional biopsy is considered the method of choice while an incisional biopsy should be avoided because of the risk of recurrence. On the other hand, incisional biopsy is used in the cases of adenoidcystic carcinoma and lymphoma. After confirmation of an adenoidcystic carcinoma by biopsy, orbital exenteration has to follow as soon as possible. In cases of lymphoma, possible oncological treatment has to be evaluated. In order to differentiate histologically between a reactive lymphoid hyperplasia and a malignant lymphoma, immunofluorescent studies on non-fixed tissue are necessary in close collaboration with an immuno-pathologist. Because the benign pleomorphic adenoma of the lacrimal gland has to be treated by a different surgical approach than the adenoid cystic carcinoma, a proper diagnosis has to be made before any intervention; a requirement we could not always fulfill. Those mistakes made us conclude that even in the era of CT scan, MRI and angiography, the radiological diagnoses are often hypotheses which have to be confirmed by discussion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Neoplastic space-occupying lesions of the orbits. II. Space-occupying lesion in the area of the lacrimal gland]. 133 68

We report a 44-year-old male with a thyrotropin (TSH)-secreting pituitary adenoma. Based serum free triiodothyronine (FT3, 12.1 pmol/l) and free thyroxine (FT4, 28 pmol/l) were increased with normal basal TSH (3.1 mU/l). There was impaired TSH response to thyrotropin releasing hormone (TRH) test. Serum TSH was suppressed to 59% of the basal level after oral administration of 1.4 mg 3,3'-5-triiodothyroacetic acid (triac), whereas no suppression was observed after 75 micrograms daily administration of triiodothyronine (T3). Serum concentrations of alpha-subunit of TSH (TSH-alpha) and TSH-alpha/TSH molar ratio were high, being 1.95 micrograms/l, and 4.4, respectively. Pituitary CT and MRI scan showed the presence of a macroadenoma in the anterior lobe of the pituitary gland. Histopathology of the excised pituitary confirmed the diagnosis of a TSH-producing adenoma. A positive correlation between TSH and FT3 (r = 0.66, P less than 0.01) or FT4 (r = 0.54, P less than 0.01) was observed in serial sera obtained before and after operation.
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PMID:Thyrotropin-secreting pituitary adenoma: a case report. 144 57

In 115 patients with pituitary macroadenomas, the findings on mid-field MRI were correlated with the hormonal activity of the tumours. Adenomas secreting growth hormone (GH), prolactin (PRL) and clinically nonsecretory adenomas were studied. Tumour size, invasiveness and signal intensity patterns were recorded. Relaxation times and ratios of signal intensity and proton density (relative to the corpus callosum) were analysed in areas of apparently solid tissue in a subgroup of 59 previously untreated patients. Invasiveness was more common in PRL- and GH-secreting adenomas than in the nonsecreting ones. Diffuse invasion of the base of the skull was most common in prolactinomas, and associated with a lower frequency of suprasellar tumour extension. In prolactinomas, a correlation was found between the maximum serum PRL level and tumour size. Haemorrhagic, cystic or necrotic areas were less common in GH-secreting tumours than in the other types. Haemorrhage was more common in prolactinomas than in nonsecreting tumours. MR parameters were similar in prolactinomas and nonsecreting adenomas, but indicated a smaller amount of water in GH-secreting tumours.
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PMID:MRI of pituitary macroadenomas with reference to hormonal activity. 155 37

A retrospective MRI and ultrasound (US) study of 50 patients with hyperparathyroidism and no history of thyroid disease was done. The purpose was to compare the sensitivity of both methods in the detection of asymptomatic thyroid nodules, as well as to determine the prevalence of thyroid abnormalities in patients with hyperparathyroidism. All the patients underwent MR and 33 were also studied by high-resolution US. Magnetic resonance imaging was performed on a 1.5 T unit, using T1-(500-700/20) and T2-(2,000/20 and 70) weighted images. Axial sections (5 mm with a 1 mm interval between them) were obtained along the neck. Ultrasonography was performed using a 10 MHz linear array transducer. The prevalence of thyroid nodules was 46% in the 50 patients studied by MR imaging. In the subgroup of patients studied by both methods, US depicted nodules in 48% of patients, and MR depicted nodules in 45%. Magnetic resonance imaging and US detected a high frequency of thyroid nodules in patients with hyperparathyroidism. This high frequency makes the detection of an intrathyroidal parathyroid adenoma problematic.
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PMID:MRI and ultrasound detection of asymptomatic thyroid nodules in hyperparathyroidism. 162 23

A rare occurrence of the association of parathyroid adenoma in a case of thyroid papillary carcinoma is described. The patient was incidentally found to have parathyroid adenoma which was preoperatively diagnosed to be a metastatic lymph node. Analysis of her serum obtained before operation showed an elevation of serum parathyroid hormone (PTH) concentration without hypercalcemia. Since the association of hyperparathyroidism is high in patients with thyroid diseases, examination of not only serum levels of calcium and PTH but also careful interpretation of computed tomography (CT) and/or nuclear magnetic imaging (MRI) is necessary in the diagnosis of co-existing asymptomatic hyperparathyroidism.
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PMID:A case of papillary carcinoma of the thyroid associated with parathyroid adenoma without hyperparathyroidism. 163 47

MRI has clearly improved the visualization of the perisellar region. Its full role in the diagnosis of pituitary adenomas remains to be defined. It is likely that three-dimensional Fourier transform thin-section imaging of the gland will further refine the diagnosis of adenoma, allowing not only for the visualization of tiny adenomas, but possibly helping to distinguish them from other nonadenomatous intraglandular abnormalities.
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PMID:Imaging of pituitary gland tumors. 164 6

We report on a patient with ACTH and FSH producing invasive pituitary adenoma complaining of cutaneous pigmentation. Elevations in plasma ACTH, beta-endorphin and cortisol levels as well as urinary 17-OHCS and cortisol excretion were found. Serum FSH concentration was just within the upper limit of the normal range, whereas serum LH level was reduced and alpha-subunit level was normal. Roentogenographic examination showed an almost complete loss of sellar floor and destruction of the posterior clinoids and dorsum sella. CT scan and MRI demonstrated an enlarged tumor invasion of the clivus and its extension to the sphenoid sinus. After subtotal removal of the large pituitary tumor, serum cortisol and plasma beta-endorphin levels as well as plasma ACTH concentrations returned to normal and serum FSH levels also remarkably decreased. Histologically, the tumor corresponded to a chromophobe, slightly PAS positive adenoma. These tumor cells exhibited positive immunostaining with antibody to ACTH (1-24), beta-LPH, beta-endorphin and FSH, while immunostaining of the adenoma cells was negative for LH, TSH, GH and prolactin. The immunogold technique also demonstrated ACTH and FSH particles in the secretory granules in the cytoplasm of the adenoma cells. Some of the tumor cells disclosed Crooke's hyalinization and type I microfilament occupied most of the cytoplasm. In the present study, a very rare case of ACTH and FSH producing invasive pituitary adenoma is reported.
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PMID:An ACTH and FSH producing invasive pituitary adenoma with Crooke's hyalinization. 171 63

A quantitative analysis of signal relationships using T1, proton and T2 weighted spin echo sequences was carried out using 20 parathyroid adenomas demonstrated by MRI. T1 weighted sequences from 15 adenomas were also examined following intravenous injection of Gd-DTPA. No typical signal relationship could be defined. In 4 cases the administration of contrast medium markedly increased the contrast between the adenoma and the thyroid gland. In 12 cases the tumour could be examined histologically following removal. In 2 cases there was oedema of the tumour and corresponding increased intensity of the T2 weighted sequences; in none of the other cases was there any clear correlation between the signals and the histology.
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PMID:[The signal behavior of parathyroid adenomas in MRT--the contrast ratio of the thyroid and fatty tissue]. 173 70


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