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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sheehan's syndrome frequently causes hypopituitarism either immediately or after a delay of several years, depending on the degrees of postpartum ischemic pituitary necrosis. A 55 year-old woman whose last child was born 27 yr ago with massive hemorrhage was diagnosed as postpartum hypopituitarism. She had deficiency of growth hormone, prolactin, gonadotropins and thyrotropin. However, she interestingly had apparent hypercortisolism without suppression response to the dexamethasone tests. We found an adrenal mass with distant metastases to the liver and lung while investigating the origin of the hypercortisolism. Hyperandrogenism and very high levels of 17alpha hydroxyprogesterone were present. Accordingly, the patient was diagnosed as hypopituitarism due to Sheehan's syndrome accompanied by Cushing's syndrome as a result of an adrenocortical carcinoma.
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PMID:A case of postpartum hypopituitarism accompanied by Cushing's syndrome as a result of an adrenocortical carcinoma. 1586 51

We report a rare case of primary aldosteronism due to an adrenocortical carcinoma. A 61-year-old woman with a history of hypertension and hypokalemia was referred for evaluation of a 4.2 cm measuring adrenal mass without secondary signs of malignancy. Endocrinological testing was consistent with primary aldosteronism. The patient underwent surgical resection of the adrenal mass; histology revealed an adrenocortical carcinoma. Postoperatively blood pressure, serum potassium, and aldosterone returned to normal. Four months after adrenalectomy, the patient presented again with hypokalemic hypertension and was found to have metastatic disease. Endocrinological investigation revealed primary aldosteronism and subclinical autonomous glucocorticoid hypersecretion. Careful hormonal investigation should be obtained in patients with adrenal masses causing excessive aldosterone secretion. In uncertain cases of primary aldosteronism, we would suggest to measure 18-hydroxycortisol levels, as excessive amounts may indicate adrenocortical carcinoma.
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PMID:Steroid profile in an adrenocortical carcinoma producing aldosterone. 1589 61

In this study we have analyzed 84 patients (58 women, 26 men, mean age 57 +/- 1.1 year) hospitalized in the Department of Nephrology, Endocrinology and Metabolic Diseases of the Medical University of Silesia in Katowice from 01.01.1999 to 30.04.2003 because of incidentally discovered adrenal tumors (incidentaloma). The diameter of the tumors ranged from 8 to 86 mm (mean size 35.4 +/- 1.8 mm). Unilateral tumors were found in 74 patients and bilateral ones in 10 patients. In all patients circadian rhythm of plasma cortisol concentration and urinary cortisol excretion were measured. In 73 patients with a history of hypertension plasma renin activity was estimated in basal conditions and after stimulation by sodium restriction and upright position. Aldosteronemia and urinary metoxycatecholamines excretion were also determined. 45 patients with tumors >4 cm and/or with suspicion of malignancy or hormonal hypersecretion were qualified for surgical treatment. Thirty two patients out of the selected 45 have been operated so far. In two patients histopathological examination confirmed malignancy (adrenocortical carcinoma in one patient and metastatic cancer in the other one). The remaining 30 patients were operated because of size of the adrenal mass (16 patients) or biochemical suspicion of pheochromocytoma (12 patients, 5 of them with the mass size >4 cm) or primary aldosteronism (2 patients). The histological examination confirmed Conn syndrome in two patients and pheochromocytoma in one patient.
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PMID:[Clinical, biochemical and hormonal characteristics of 84 patients with incidentally found adrenal tumor (incidentaloma)]. 1596 10

Malignant melanoma is an extremely aggressive form of cancer. Adrenal metastases are found in 50% of cases of malignant melanoma, and are most often clinically and biochemically silent. Clinical presentation varies, and the diagnosis of adrenal metastases is often made incidentally, and frequently years after treatment of the primary lesion. An adrenal mass lesion seen on a CT scan, greater than 5 cm in diameter, with central or irregular areas of necrosis/haemorrhage (and no lipomatous component) is characteristic of a metastasis from malignant melanoma, in the setting of normal gland function. If these features are bilateral, they are pathognomonic. Oval, low-attenuation (on CT) adrenal masses less than 3 cm in diameter should not be considered benign in a patient with any prior history of melanoma. Careful imaging review of the adrenal glands should be undertaken in all patients with malignant melanoma. Early diagnosis of these distant metastases has important prognostic and therapeutic implications. The four cases presented illustrate the spectrum of presentations and clinical course of adrenal metastases from malignant melanoma. The accompanying CT images show the characteristic appearances of adrenal metastases.
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PMID:Adrenal metastases of malignant melanoma: characteristic computed tomography appearances. 1602 41

Solid pseudopapillary tumors are rare pancreatic neoplasms of uncertain pathogenesis that rarely metastasize and usually occur in young women. We describe the clinical, imaging, and cytopathological features of solid pseudopapillary tumor of the pancreas. We reviewed the clinical presentation, imaging, morphologic/immunochemical features, and follow-up of three women (age range 26-44). Cases 1, 2, and 3 presented with abdominal wall abscess, multiple endocrine neoplasia, and solid/cystic mass in the pancreatic head, respectively, and computed tomography of abdomen revealed solid/cystic masses with heterogeneous enhancement in body, tail and head of the pancreas, respectively. Case 2 also exhibited a left adrenal mass. Case 3 underwent endoscopic ultrasound of the pancreas, which showed a complex solid/cystic mass with septations. Sampling consisted of fine-needle aspiration (percutaneous or endosonography-guided), and additionally, core biopsy of the pancreatic mass and adrenal lesion in case 2. Aspirates and core biopsy revealed vascular structures with attached monotonous neoplastic cells in papillary-like arrays. Tumor cells had bland nuclear features with grooves, cytoplasmic periodic acid Schiff-positive hyaline globules, and associated myxoid/stromal fragments. Immunochemistry expressed alpha-1-antitrypsin, alpha-1-antichymotrypsin, vimentin, and focal neuron-specific enolase. Cases 1 and 3 underwent pancreatectomy with follow-up consisting of yearly imaging and no recurrences. Case 2 proved metastatic disease to adrenal gland and no follow-up was available. In the setting of typical clinical and imaging findings, an accurate preoperative diagnosis of pancreatic solid pseudopapillary tumor can be established by aspiration cytology and immunochemistry with or without concomitant core biopsy, on the basis of which clinicians decide treatment. This tumor can behave in a malignant fashion.
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PMID:Clinical, imaging, and cytopathological features of solid pseudopapillary tumor of the pancreas: a clinicopathologic study of three cases and review of the literature. 1638 90

Percutaneous computed tomography (CT)-guided radiofrequency (RF) ablation has been used in the palliative treatment of symptomatic bilateral adrenal tumors, often with each tumor addressed separately over the course of multiple treatment sessions. In the present case, a 71-year-old man with a diagnosis of lung cancer and painful bilateral metastases to the adrenal glands underwent percutaneous CT-guided RF thermal ablation of both adrenal masses in a single session (left adrenal mass, 4.7 cm; right adrenal mass, 4.3 cm), without occurrence of blood pressure instability or other acute complications. Measurement of plasma levels of cortisol, adrenocorticotropic hormone (ACTH), and glucose before and after RF ablation revealed transient changes that suggested preservation of endocrine feedback mechanisms. The patient experienced marked relief in pain bilaterally. By 5 days after the procedure, cortisol, ACTH, and glucose levels returned to preprocedural levels. On further follow-up at 6 months, the patient noted a lack of endocrine sequelae and continued pain relief.
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PMID:Percutaneous CT-guided radiofrequency ablation of symptomatic bilateral adrenal metastases in a single session. 1641 49

Neuroblastoma of the adrenal gland is an extremely rare tumour in adulthood although it is one of the most common malignancies in childhood. In this report, we present a 52-year-old man who had a left adrenal mass on preoperative imaging. On laboratory, slightly elevated catecholamine metabolites were detected in the urine that was collected over 24 hours. He was operated and the mass was resected in en-block manner along with the regional lymph nodes. The histopathological examination of the specimen revealed the diagnosis of neuroblastoma. He had no metastatic disease at the time of diagnosis and received chemotherapy after the operation. However, the prognosis was poor and he died 10 months after the operation. Although neuroblastoma of adrenal gland is rare in adulthood, it should be considered in the differential diagnosis for patients with adrenal masses.
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PMID:An adult adrenal neuroblastoma: a case report. 1643 86

We describe a case of long-term survival following multimodality treatment of metachronous metastases (parotid gland, adrenal gland, brain and mediastinal lymph node) after resection of non-small cell lung cancer. A 72-year-old man had a past history of right upper lobectomy for pT3N0M0 tubular adenocarcinoma of the lung 12 years ago and left lower lobectomy for pT3N1M0 papillary adenocarcinoma of the lung 42 months ago, and left parotidectomy and irradiation to the neck for parotid metastasis 20 months ago. A progressive increase in serum CEA level during the follow-up period revealed a 5 cm left adrenal mass and small (1 cm or less) multiple brain metastases, and a 2 cm mediastinal lymph node. He underwent adrenalectomy and gamma knife surgery and received irradiation to the mediastinum, and was administered gefitinib as first-line chemotherapy for about a year. Brain metastases recurred despite 4 more rounds of gamma knife surgery and 4 cycles of docetaxel hydrate as second-line chemotherapy, and 1 cycle of vinorelbine ditartrate as third-line chemotherapy. He died of multiple brain metastases 65 months postoperatively. We confirm the possibility of long-term survival following multimodality treatment even though multiple organ metastases were found after resection of non-small cell lung cancer.
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PMID:[Long-term survival following multimodality treatment of metachronous metastases (parotid gland, adrenal gland, brain and mediastinal lymph node) after resection of non-small cell lung cancer; report of a case]. 1648 16

We report a case of metachronous bilateral adrenal metastases from mucinous adenocarcinoma of the stomach. A 68-year-old man who had undergone surgery for advanced gastric cancer 5 months earlier had a follow-up computed tomography (CT) scan, which showed a right adrenal tumor. We performed a right adrenalectomy, and histopathological examination revealed a mucinous adenocarcinoma with features consistent with those of gastric cancer. A routine follow-up CT scan done 41 months after the right adrenalectomy showed a left adrenal mass. Chemotherapy had no apparent effect, and left adrenalectomy was performed 65 months after the right adrenalectomy. Histopathological examination also revealed a metastasis from gastric cancer. The patient was alive without recurrence 40 months after the left adrenalectomy. This case suggests that resection of adrenal metastasis from gastric cancer is an effective treatment option that may prolong survival in selected patients.
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PMID:Long-term survival after resection of metachronous bilateral adrenal metastases of mucinous gastric carcinoma: report of a case. 1671 29

A 56-yr-old man was admitted to our university hospital for severe back pain one month after a resection for lung adenocarcinoma (stage IIIA) without evidence of the adrenal mass. Computed tomography (CT) of the abdomen showed bilateral bleeding of adrenal tumors. Endocrinological laboratory studies showed high plasma ACTH and normal serum cortisol levels with the loss of circadian rhythm. Although plasma ACTH levels increased, there was no cortisol response to administration of human corticotropichormone (hCRH). Core-needle biopsy was performed on the right adrenal tumor and revealed adenocarcinoma cells mimicking a primary lung tumor previously examined. We diagnosed retroperitoneal hemorrhage due to bilateral adrenal gland metastasis from lung adenocarcinoma with adrenal insufficiency. Adrenal metastases most commonly originate from a primary lung tumor, followed by stomach, esophagus and liver/bile ducts. Bilateral adrenal metastases were noted in approximately half of all adrenal metastases patients. Clinically significant adrenal hemorrhage by metastasis is exceedingly rare and non-specific symptoms, such as abdominal, chest or back pain, nausea and vomiting, confusion, weakness, hypotension, shock and high fever, are often observed in these patients. We present a case of massive retroperitoneal hemorrhage and adrenal insufficiency due to adrenal gland metastasis from adenocarcinoma of lung.
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PMID:Retroperitoneal hemorrhage due to bilateral adrenal metastases from lung adenocarcinoma. 1684 Aug 34


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