scholarly journals Diagnosis and Treatment of Adrenal Medullary Hyperplasia: Experience from 12 Cases

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Lu Yang ◽  
Liang Gao ◽  
Xiao Lv ◽  
Shengqiang Qian ◽  
Siyuan Bu ◽  
...  
Keyword(s):  
Left Kidney ◽  
Complete Removal ◽  
Spindle Cell Carcinoma ◽  
Diagnosis And Treatment ◽  
Partial Adrenalectomy ◽  
Unilateral Adrenalectomy ◽  
Adrenal Medullary Hyperplasia ◽  
Satisfactory Outcome ◽  
Effective Choice

Objective. To dissect the characteristics of adrenal medullary hyperplasia (AMH) and share our experience of diagnosis and treatment of AMH.Methods. From 1999 to 2013, 12 cases of AMH have been pathologically diagnosed after operation in our hospital. The clinical characteristics, process of diagnosis, treatment, and prognosis during follow-up of all patients are summarized retrospectively.Results. Four cases were trended to be AMH and 6 cases were trended to be pheochromocytoma before operation; moreover, the other two patients were diagnosed accidentally. All patients, except for the patient with mucinous tubular and spindle cell carcinoma of left kidney by open surgery, experienced a smooth laparoscopic adrenalectomy, including 2 with radical nephrectomy, 10 of which experienced unilateral adrenalectomy, 1 was bilaterally partial adrenalectomy, and the remaining one was unilaterally complete removal and then 2/3 partially contralateral excision. After a medium follow-up of 6.5 years, it demonstrated a satisfactory outcome of 8 cured patients and 4 symptomatic improved patients.Conclusions. AMH presents a mimicking morphology and clinical manifestation with pheochromocytoma. Surgery could be the only effective choice for the treatment of AMH and showed a preferable prognosis after a quite long follow-up.

scholarly journals Renal mucinous tubular and spindle cell carcinoma

2008 ◽  
Vol 2 (6) ◽  
pp. 635 ◽  
Author(s):  
Amel Trabelsi ◽  
Wided Stita ◽  
Mohamed Tahar Yacoubi ◽  
Soumaya Rammeh ◽  
Sihem Hmissa ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Epithelial Membrane Antigen ◽  
Spindle Cell ◽  
Left Kidney ◽  
Papillary Renal Cell Carcinoma ◽  
Spindle Cell Carcinoma ◽  
Cytokeratin 7 ◽  
Myxoid Stroma

We report a case of mucinous tubular and spindle cell carcinoma in a 66-year old woman. The tumour, located on the left kidney, was well circumscribed. Microscopically, the tumour was composed of cuboidal cells arranged in tubules and making abrupt transitions to spindle cell morphology in a myxoid stroma. Tumour cells were strongly positive for cytokeratin 7 and epithelial membrane antigen. Because of the favourable prognosis with this type of tumour, mucinous tubular and spindle cell carcinoma must be differentiated from papillary renal cell carcinoma, especially that with sarcomatoid change. No tumour recurrence or metastasis were reported with a follow-up of 23 months.

Computed tomographic findings and treatment of an unusual fracture of the proximal ulna in a mature dog

2011 ◽  
Vol 24 (02) ◽  
pp. 161-164
Author(s):  
T. Trevail ◽  
E. J. Comerford ◽  
R. D. Hattersley
Keyword(s):  
Computed Tomography ◽  
Surgical Planning ◽  
Kirschner Wire ◽  
Normal Function ◽  
Labrador Retriever ◽  
Diagnosis And Treatment ◽  
Proximal Ulna ◽  
Computed Tomographic ◽  
Satisfactory Outcome

SummaryThis report describes the diagnosis and treatment of an unusual fracture of the proximal ulna in a four-year-old male neutered Labrador Retriever dog, the orientation of which has not been reported in the veterinary literature. Computed tomography allowed fracture visualisation and aided surgical planning. Fixation was achieved using a lag screw and an anti-rotational Kirschner wire. Six month follow-up indicated satisfactory outcome with complete return to normal function.

scholarly journals Postoperative Outcomes of Familial Adrenal Pheochromocytoma1

2011 ◽  
Vol 3 (3) ◽  
pp. 112-115
Author(s):  
Chikara Kagawa ◽  
Yatsuka Hibi ◽  
Hiroki Uchida ◽  
Sumiyo Noda ◽  
Ai Idota ◽  
...  
Keyword(s):  
Adrenocortical Function ◽  
Initial Operation ◽  
Management Options ◽  
Partial Adrenalectomy ◽  
Unilateral Adrenalectomy ◽  
Von Hippel Lindau ◽  
Initial Surgery ◽  
Familial Pheochromocytoma ◽  
Adrenal Pheochromocytoma

ABSTRACT There are no current guidelines for the management of familial pheochromocytoma (FP). We tried to determine the optimal management of patients with FP. Among 191 patients with pheochromocytoma who underwent surgical resection between 1979 and 2010, there were 18 FP (13 different kindreds; 11 females/7 males; mean age at initial operation: 38.7 years). The 18 FP cases comprised 10 with MEN2A, 2 with MEN2B, 4 with von Hippel-Lindau disease, and 2 with FP only, and all pheochromocytomas were of adrenal origin. The number of probands and family members was 9 and 9 respectively. Mean tumor size was 6.4 cm in diameter. Simultaneous bilateral adrenalectomy was performed in 6 patients, and unilateral adrenalectomy was performed as the initial surgery in 12 patients. A metachronous contralateral adrenalectomy was performed in 3 patients, 90, 236 and 312 months after the primary operation, respectively. None of the patients received partial adrenalectomy. Among another 9 patients with unilateral adrenalectomy, contralateral pheochromocytomas were suspected in 4 cases at the initial operation. However, none of these contralateral lesions developed severe symptoms or tumor enlargement during a median follow-up of 116 months. In the remaining 5 patients, pheochromocytoma did not develop in the contralateral adrenals over a median follow-up of 80.5 months. Bilateral lesions of adrenal pheochromocytoma in familial cases occurred in 78% of cases (14/18); 9 patients (including 4 with contralateral pheochromocytoma) did not require a contralateral adrenalectomy during a median follow-up of 119 months. No patients have suffered from Addisonian crisis. The ipsilateral adrenalectomy and follow-up of contralateral small pheochromocytoma is one of the management options to preserve adrenocortical function in FP patients.

Arterite de Takayasu em Gestante: Relato de Caso / Takayasu Arteritis in Pregnancy: Case Report

1970 ◽  
Vol 5 (4) ◽  
pp. 61-66
Author(s):  
Patrícia Resende Penido ◽  
Rhanna Junqueira Westin de Carvalho ◽  
Roger Willian Moraes Mendes
Keyword(s):  
Case Report ◽  
Takayasu Arteritis ◽  
Imaging Techniques ◽  
Unknown Origin ◽  
Pregnant Patient ◽  
Immunosuppressive Drugs ◽  
Clinical Treatment ◽  
Satisfactory Outcome

RESUMOIntrodução: A Arterite de Takayasu (AT) consiste em uma vasculopatia de origem indefinida, sendo de caráter crônico, que afeta a aorta e seus ramos principais. Em gestantes é uma condição complexa, em que o tratamento clínico é realizado com restrições. A utilização de corticoides tem sido favorável no controle inflamatório, principalmente naqueles casos em que antes da gravidez se fazia uso de imunossupressores. Casuística: Foi relatado um caso de uma gestante portadora de AT, através da análise de prontuário e de exames complementares, sendo realizado o pré-natal pelas equipes de Obstetrícia e Reumatologia, onde foi realizado tratamento clínico com corticoides, mostrando uma evolução satisfatória, ocorrendo apenas uma hospitalização que foi seguida de uma cesárea na trigésima sexta semana de gravidez, com recém nato saudável de 3.810g. Discussão: A AT pode estar associada a várias etiologias, sendo a gênese pouco conhecida. O diagnóstico na maioria das vezes é demorado, pela dificuldade da suspeita clínica, além de demandar o uso de técnicas de imagem mais sofisticadas. A gestação associada é fenômeno raro, já que as portadoras são orientadas a evitarem a gravidez. O controle clínico permitiu uma gestação sem grandes complicações e serviu como meio para levar a gestação até praticamente o fim do terceiro trimestre. Conclusão: Deve-se ressaltar o papel do acompanhamento clínico, especialmente com esta pan-arterite, mostrando os medicamentos que podem ser utilizados nesse grupo, especialmente quando se usava imunossupressores antes da gravidez. Palavras chave: Arterite de Takayasu, Gravidez, Vasculite. ABSTRACT:Introduction: Takayasu's arteritis (TA) consists of a vascular disease of unknown origin and chronic nature, which affects the aorta and its main branches. In pregnant women it is a complex condition, in which the clinical treatment is performed with restrictions. The use of corticosteroids has been favorable to control inflammation, especially in those cases when immunosuppressant had been used before pregnancy. Case Report: A case of a pregnant patient with TA has been reported through the analysis of medical records and laboratory tests. The Obstetrics and Rheumatology staff performed the prenatal care, and clinical treatment with corticosteroids was done showing a satisfactory outcome. There was only one hospitalization of the patient, which was followed by a cesarean in the thirty sixth week of pregnancy.  The newborn was a healthy one, weighing 3.810g. Discussion: TA may be associated with several etiologies, and the genesis is little known. The diagnosis most often takes time due to the difficulty of clinical suspicion, and requires the use of more sophisticated imaging techniques. The pregnancy is rare phenomenon, since the carriers are advised to avoid pregnancy. The clinical management allowed a pregnancy without major complications and served as a means to carry the pregnancy to almost the end of the third quarter. Conclusion: The role of the clinical follow-up should be noticed especially with this pan-arteritis, showing the drugs that can be used in this group, especially when there is use of immunosuppressive drugs before pregnancy. Keywords: Takayasu Arteritis, Pregnancy, Vasculitis.

scholarly journals Parenchymal mucinous cystadenoma of the kidney: a case report and literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mahmoudreza Kalantari ◽  
Shakiba Kalantari ◽  
Mahdi Mottaghi ◽  
Atena Aghaee ◽  
Salman Soltani ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Left Kidney ◽  
Previous History ◽  
Mucinous Cystadenoma ◽  
Single Layer ◽  
Renal Cysts ◽  
Cystic Mass ◽  
Flank Pain ◽  
History Of

Abstract Background Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts. Case presentation A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month. Conclusion It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.

Endoscopy-assisted removal of periorbital inclusion cysts in children

2011 ◽  
Vol 7 (2) ◽  
pp. 161-164 ◽  
Author(s):  
George Chater-Cure ◽  
Caitlin Hoffman ◽  
Jared Knopman ◽  
Samuel Rhee ◽  
Mark M. Souweidane
Keyword(s):  
High Speed ◽  
Complete Removal ◽  
Skin Incision ◽  
Clinical Findings ◽  
Complete Excision ◽  
Alternative Approach ◽  
Cyst Recurrence ◽  
Scalp Incision ◽  
Access Technique

Object Surgical treatment for periorbital inclusion cysts typically involves a brow, pterional, or partial bicoronal scalp incision for sufficient exposure. The authors have recently employed an endoscopy-assisted technique as an alternative approach intended to minimize the length of the skin incision and avoid scarring in the brow. Methods Children having typical clinical findings of a dermoid cyst located on the hairless forehead were selected to undergo endoscopy-assisted cyst removal. For suspected intradiploic lesions, MR imaging was used to assess osseous involvement. After induction of general anesthesia, a 1–2-cm curvilinear incision was made posterior to the hairline. A 30°-angled endoscope (4 mm) was then used for dissection in the subgaleal compartment. Subgaleal dissection was followed by a circumferential periosteal incision in which the authors used an angled needle-tip unipolar cautery. For lesions within the diploe, a high-speed air drill was used to expose the lesion. Complete removal was accomplished with curettage of either the skull or dural surface. Results Eight patients (5–33 months of age) underwent outpatient endoscopic resection. Seven cysts were extracranial, and 1 cyst extended through the inner table. In all patients complete excision of the cyst was achieved. There was negligible blood loss, no dural violation, and no postoperative infection. There have been no recurrences at a mean follow-up of 15 months. Conclusions Endoscopy-assisted resection of inclusion cysts of the scalp and calvaria is a safe and effective surgical approach. The technique results in negligible incisions with less apparent scarring compared with previously described incisions. This limited-access technique does not appear to be associated with a higher incidence of cyst recurrence.

scholarly journals Carcinosarcomas of the larynx: systematic review of the literature of a rare nosologic entity

2021 ◽  
Author(s):  
Andrea Colizza ◽  
Antonio Gilardi ◽  
Antonio Greco ◽  
Fabrizio Cialente ◽  
Federica Zoccali ◽  
...  
Keyword(s):  
Overall Survival ◽  
Data Extraction ◽  
Treatment Guideline ◽  
Cancer Staging ◽  
Spindle Cell Carcinoma ◽  
Nodal Metastasis ◽  
Partial Laryngectomy ◽  
Rare Type ◽  
Rare Malignancy

Abstract Purpose Carcinosarcoma, also known as Spindle Cell Carcinoma (SpCC), is a rare type of malignant tumor. Generally, this type of pathology occurs in the urogenital tract, the gastrointestinal tract, respiratory tract and mammary gland; in the larynx, SpCC represents only 2–3% of all malignancies. Due to its rarity, there is currently no generally acceptable treatment guideline for this disease. The aim of this study was to systematically review the literature of SpCC of larynx and report epidemiologic, clinicopathologic and main therapeutic approaches for this entity. Methods A systematic literature review was performed using MEDLINE, EMBASE, PubMed and Scopus databases. For this review, the results were extrapolated in the period between January 1990 to September 2020. Data extraction was performed using a standard registry database. The clinical and pathological staging were recalculated according to the Eight Edition of AJCC Cancer Staging Manual and statistical analyses were performed using SPSS Version 25.0. Results A total of 111 patients affected by laryngeal carcinosarcoma were included. From our review arises that surgery is the main treatment for primary laryngeal carcinosarcoma. In this way, various techniques such as minimally invasive laryngoscopy excision, laser CO2 cordectomy, partial laryngectomy (vertical and horizontal) and total laryngectomy. The role of radiotherapy is still controversial. The overall survival (OS) for T1 stage tumor at 5 years of follow-up is 82.9%, the OS for T2 and T3 tumor is 74% and 73.4%. The OS at 5 years of follow-up is 91.7% for supraglottic tumor, 69.3% for glottic tumor and 50% for transglottic site. Subglottic site is described in only 2 cases [12–13], so the OS at 5 years is not statistically significant. The 5-year overall survival in patients without lymph nodes involvement (N0) is 90.2%, 66.7% and 50%, respectively, for N1 and N2 lesions. Conclusion Primary laryngeal carcinosarcoma is a very rare malignancy. There are no clear guidelines in the management but in the literature, surgery is described as the best modality of therapy; radiation only can be a reasonable alternative with controversial efficacy. The most important prognostic factor is the nodal metastasis.

Postnatal ultrasound follow-up in neonates with prenatal hydronephrosis

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Elham Kebriyaei ◽  
Ali Davoodi ◽  
Seyed Alinaghi Kazemi ◽  
Zahra Bazargani
Keyword(s):  
Ultrasound Imaging ◽  
Maternal Education ◽  
Left Kidney ◽  
Ultrasound Images ◽  
Fetal Ultrasound ◽  
Renal Anomalies ◽  
Cross Sectional ◽  
Fetal Hydronephrosis ◽  
Kidney Involvement

Abstract Objectives Renal anomalies are the most common fetal abnormalities that occur during prenatal development, and are typically detected by observing hydronephrosis on fetal ultrasound imaging. Follow-up with post-natal ultrasound is important to detect clinically-important obstruction, because many of the pre-natal abnormalities resolve spontaneously. This study aimed to evaluate the postnatal hydronephrosis follow-up rate, and reasons for non follow-up in affected neonates. Methods In this cross-sectional study all neonates born during a period of one year at Ayatollah Mousavi Hospital with hydronephrosis on fetal ultrasound imaging were recruited. All mothers were also given face-to-face information about fetal hydronephrosis and its postnatal outcomes, and follow-up with at least a postnatal ultrasound was recommended from the fourth day of their neonates’ birth until the end of the fourth week. The neonates were subsequently observed for one month to determine the postnatal ultrasound follow-up rate and to reflect on diagnostic test results, reasons for failure to follow-up, as well as causes of hydronephrosis. Results In this study, 71 cases (1.2%) out of 5,952 neonates had fetal hydronephrosis on prenatal ultrasound images. The postnatal ultrasound imaging showed kidney involvement in 18 neonates (25%), particularly in the left kidney (61.1%). Seven neonates had no follow-up at one month (10%). No significant relationship was found between lack of follow-up and the neonates’ place of residence (p=0.42), maternal education (p=0.90), number of siblings (p=0.33), or gender (p=0.64). Conclusions Postnatal ultrasound follow-up rate in these neonates with a history of fetal hydronephrosis was incomplete even though parents had been provided with education and advice at their birth time. Accordingly, it is recommended to perform postnatal ultrasound once neonates are discharged from hospitals.

scholarly journals The long-term course of fatigue following breast cancer diagnosis

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Karin Biering ◽  
Morten Frydenberg ◽  
Helle Pappot ◽  
Niels Henrik Hjollund
Keyword(s):  
Breast Cancer ◽  
Time Course ◽  
Breast Cancer Diagnosis ◽  
Patient Characteristics ◽  
Repeated Measurements ◽  
Diagnosis And Treatment ◽  
Persistent Problem ◽  
Treatment Regimens ◽  
Long Time

Abstract Purpose Fatigue following breast cancer is a well-known problem, with both high and persistent prevalence. Previous studies suffer from lack of repeated measurements, late recruitment and short periods of follow-up. The course of fatigue from diagnosis and treatment to the long-time outcome status is unknown as well as differences in the level of fatigue between treatment regimens. The purpose of this study was to describe the long-time course of fatigue from the time of clinical suspicion of breast cancer, its dependence of patient characteristics and treatment regimens and the comparison with the course of fatigue among women with the same suspicion, but not diagnosed with breast cancer. Methods Three hundred thirty-two women referred to acute or subacute mammography was followed with questionnaires from before the mammography and up to 1500 days. Fatigue was measured by the Multidimensional Fatigue Inventory (MFI-20). The women reported their initial level of fatigue before the mammography and thus without knowledge of whether they had cancer or not. Both women with and without cancer were followed. Women with cancer were identified in the clinical database established by Danish Breast Cancer Cooperative Group (DBCG) to collect information on treatment regimen. Results Compared to fatigue scores before diagnosis, women with breast cancer reported a large increase of fatigue, especially in the first 6 months, followed by a slow decrease over time. Despite the long follow-up period, the women with breast cancer did not return to their level of fatigue at time of the mammography. Women without breast cancer, experienced a rapid decrease of fatigue after disproval of diagnosis followed by a steadier period. Conclusions Fatigue is a persistent problem in women diagnosed with breast cancer, even several years following diagnosis and treatment. The women with breast cancer were most affected by fatigue in the first 6 months after diagnosis.

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